Psoriatic arthritis diagnostic study of choice
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]
Overview
Diagnostic Study of Choice
Diagnostic Criteria
- The diagnosis of psoriatic arthritis is easily confirmed when the cutaneous manifestations of psoriasis coexist with arthritis.[1][2][3][4]
- It must be differentiated from other arthritides based on the joint involvement patterns, clinical features, imaging and laboratory studies.
- The following manifestations may be helpful in diagnosing psoriatic arthritis in an individual in the absence of psoriatic skin lesions.[5]
| Family history of psoriasis in first degree relatives |
| Asymmetric joint distribution |
| Involvement of distal joints |
| Nail involvement (eg, pitting, nail bed destruction, onycholysis) |
| Dactylitis |
| Hidden psoriatic plaques |
- The CASPAR criteria (ClASsification criteria for Psoriatic ARthritis):[6]
- The CASPAR study stated that a patient present with inflammatory articular disease (inflammatory peripheral arthritis, enthesitis, spondylitis) can be diagnosed as having psoriatic arthritis if a total of at least three points are present from the presence of the following possibilities.
| Manifestation | Point score |
|---|---|
| Skin lesions | Current psoriasis: 2 points
Previous history of psoriasis: 1 point The family history of psoriasis: 1 point |
| Dactylitis | 1 point |
| Nail dystrophy | 1 point |
| Juxtra articular new bone formation | 1 point |
| Abscence of rheumatoid factor | 1 point |
- The specificity is approximately 98.7% and sensitivity is approximately 91.4%.
References
- ↑ Liu JT, Yeh HM, Liu SY, Chen KT (September 2014). "Psoriatic arthritis: Epidemiology, diagnosis, and treatment". World J Orthop. 5 (4): 537–43. doi:10.5312/wjo.v5.i4.537. PMC 4133459. PMID 25232529.
- ↑ WRIGHT V (December 1956). "Psoriasis and arthritis". Ann. Rheum. Dis. 15 (4): 348–56. PMC 1006908. PMID 13395269.
- ↑ Helliwell PS, Taylor WJ (March 2005). "Classification and diagnostic criteria for psoriatic arthritis". Ann. Rheum. Dis. 64 Suppl 2: ii3–8. doi:10.1136/ard.2004.032318. PMC 1766878. PMID 15708931.
- ↑ Punzi L, Pianon M, Rossini P, Schiavon F, Gambari PF (April 1999). "Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease". Ann. Rheum. Dis. 58 (4): 226–9. PMC 1752862. PMID 10364901.
- ↑ Scarpa R, Cosentini E, Manguso F, Oriente A, Peluso R, Atteno M, Ayala F, D'Arienzo A, Oriente P (December 2003). "Clinical and genetic aspects of psoriatic arthritis "sine psoriasis"". J. Rheumatol. 30 (12): 2638–40. PMID 14719207.
- ↑ Taylor W, Gladman D, Helliwell P, Marchesoni A, Mease P, Mielants H (August 2006). "Classification criteria for psoriatic arthritis: development of new criteria from a large international study". Arthritis Rheum. 54 (8): 2665–73. doi:10.1002/art.21972. PMID 16871531.