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Psoriatic Arthritis — SCE Rheumatology MCQ

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EasySpondyloarthropathyPsoriatic ArthritisSCE Rheumatology

The CASPAR classification criteria are applied to a patient with inflammatory articular disease involving a joint, the spine or an enthesis. Which threshold and set of additional features are used to classify psoriatic arthritis?

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Correct answer: A — At least 3 points from evidence of psoriasis, nail dystrophy, negative rheumatoid factor, dactylitis and juxta-articular new bone formation

The correct answer is A. CASPAR first requires inflammatory articular disease affecting a joint, the spine or an enthesis, followed by at least 3 points. Current psoriasis scores 2 points; a personal history or family history of psoriasis scores 1 point within the psoriasis category. One point is also awarded for typical psoriatic nail dystrophy, negative rheumatoid factor, current or previous dactylitis, and radiographic juxta-articular new bone formation in a hand or foot. HLA-B27, sacroiliitis and uveitis are not scored CASPAR items. Enthesitis and peripheral arthritis may satisfy the prerequisite inflammatory articular disease but do not themselves contribute points. Option D gives the wrong threshold.

Reference: Taylor W et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis & Rheumatism. 2006;54(8):2665–2673. https://pubmed.ncbi.nlm.nih.gov/16871531/