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PsA vs AS Uveitis — SCE Rheumatology MCQ

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ModerateSpondyloarthropathyPsA vs AS UveitisSCE Rheumatology

Which statement best reflects contemporary evidence comparing uveitis associated with psoriatic arthritis (PsA) with that associated with ankylosing spondylitis (AS)?

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Reveal the answer and explanation

Correct answer: B — Uveitis is less frequent in PsA; when present, it is usually acute, anterior and unilateral, broadly resembling AS.

Explanation lettering: E = shown as A · D = shown as B · B = shown as C · A = shown as D · C = shown as E

Uveitis is less common in PsA than in axial spondyloarthritis, including AS. Contemporary PsA cohorts show that, when it occurs, it is usually acute, anterior and unilateral and may recur—broadly resembling the familiar AS-associated acute anterior uveitis phenotype. Older, small referral-centre series suggested that PsA uveitis was disproportionately bilateral, insidious, chronic or posterior, but larger recent studies do not support presenting this as the defining distinction. Therefore C is excessively absolute and based on an outdated generalisation. A is incorrect because frequency differs, even if the phenotypes overlap. B is false because PsA itself is associated with uveitis, particularly with axial disease or HLA-B27 positivity. E gives the wrong anatomical and temporal pattern.

Reference: De Vicente Delmás A, et al. Uveitis in psoriatic arthritis: study of 406 patients in a single university center and literature review. RMD Open. 2023;9:e002781. https://pubmed.ncbi.nlm.nih.gov/36635002/