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CASPAR Criteria Scoring — SCE Rheumatology MCQ

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ModerateSpondyloarthropathyCASPAR Criteria ScoringSCE Rheumatology

A 55-year-old woman has inflammatory peripheral arthritis. She has current plaque psoriasis and her mother has psoriasis. Rheumatoid factor is positive. There is no psoriatic nail dystrophy or current or previous dactylitis. A hand radiograph shows juxta-articular new bone formation, excluding osteophytes. Which statement correctly describes her classification under the CASPAR criteria?

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Correct answer: E — She scores 3 points and fulfils the criteria

The correct answer is E. Inflammatory articular disease is the CASPAR entry requirement rather than a scored item. Current psoriasis contributes 2 points and juxta-articular new bone formation contributes 1, giving the required total of 3. Her family history does not add another point because family history is scored only when current psoriasis and a personal history of psoriasis are absent. Rheumatoid factor negativity would score 1 point, but RF positivity does not exclude classification; it simply contributes no point. Thus C incorrectly double-counts the psoriasis domain, while A and B undercount the qualifying features. CASPAR criteria are classification rather than diagnostic criteria.

Reference: Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006;54:2665–2673. https://pubmed.ncbi.nlm.nih.gov/16871531/