The Classification Criteria for Psoriatic Arthritis (CASPAR) Criteria

 

The CASPAR criteria for psoriatic arthritis consist of inflammatory articular disease (joint, spine, or entheseal) with >/= 3 points from the above categories. The sensibility is 98.7% and the specificity is 91.4%.

 

1. Evidence of current psoriasis, a personal history of psoriasis, or a family history of psoriasis (2 points)
• Current psoriasis is defined as psoriatic skin or scalp disease present today as judged by a rheumatologist or dermatologist.†
• A personal history of psoriasis is defined as a history of psoriasis that may be obtained from a patient, family physician, dermatologist, rheumatologist, or other qualified health care provider.
• A family history of psoriasis is defined as a history of psoriasis in a first- or second-degree relative according to patient report. 
  
2. Typical psoriatic nail dystrophy including onycholysis, pitting, and hyperkeratosis observed on current physical examination (1 point)
3. A negative test result for the presence of rheumatoid factor by any method except latex (1 point)
4. Either current dactylitis, defined as swelling of an entire digit, or a history of dactylitis recorded by a rheumatologist (1 point)
5. Radiographic evidence of juxta-articular new bone formation appearing as ill-defined ossification near joint margins (but excluding osteophyte formation) on plain radiographs of the hand or foot (1 point)

† Current psoriasis is assigned a score of 2; all other features are assigned a score of 1

 

Modified ESSG criteria for psoriatic arthritis

 

Inflammatory spinal pain

 

Or

 

Synovitis (either asymmetrical or predominantly lower limb)

 

And

 

One or more of the following:

Positive family history of psoriasis

Psoriasis

 

 

Criteria for psoriatic arthritis (PsA) proposed by Bennett

 

Mandatory

 

1. Clinically apparent psoriasis (skin or nails)

2. Pain and soft tissue swelling and/or limitation of motion in at least one joint observed by a physician for six weeks or longer

 

Supportive

 

1. Pain and soft tissue swelling and/or limitation of motion in one or more other joints observed by a physician

2. Presence of an inflammatory arthritis in a distal interphalangeal joint. Specific exclusions: Bouchard’s or Heberden’s nodes

3. Presence of "sausage" fingers or toes

4. An asymmetrical distribution of arthritis in the hands and feet

5. Absence of subcutaneous nodules

6. A negative test for rheumatoid factor in the serum

7. An inflammatory synovial fluid with a normal or increased C3 or C4 level and an absence of infection (including acid fast bacilli) and crystals of monosodium urate or pyrophosphate

8. A synovial biopsy showing hypertrophy of the synovial lining with a predominantly mononuclear cell infiltration and an absence of granuloma or tumour

9. Peripheral radiographs showing erosive arthritis of small joints with a relative lack of osteoporosis. Specific exclusion: erosive osteoarthritis

10. Axial radiographs showing any of the following: sacroiliitis, syndesmophytes, paravertebral ossification

 

Definite PsA: mandatory plus six supportive

Probable PsA: mandatory plus four supportive

Possible PsA: mandatory plus two supportive

 

 

 

 

 

Psoriatic arthritis criteria of Fournié

 

Cut-off for diagnosis of psoriatic arthritis = 11 points

 

Criterion Points

6 Psoriasis antedating or concomitant with joint symptom onset 6

 

3 Family history of psoriasis (if criterion 1 negative) or psoriasis post dating joint symptom onset 3

 

3 Arthritis of a distal interphalangeal joint 3

 

1 Asymmetrical monarthritis or oligoarthritis 1

 

2 Buttock pain, heel pain, spontaneous anterior chest wall pain, or diffuse inflammatory pain in the entheses 2

 

5 Radiological criterion 5 (any onecriterion present)

 

 

 

6 Human leucocyte antigen (HLA)-B16 (38, 39) or B17 6

 

4 Negative rheumatoid factor 4

 

 

Modified McGonagle criteria for psoriatic arthritis

 

Psoriasis or family history of psoriasis

 

Plus any one of:

 

Clinical inflammatory enthesitis

Radiographic enthesitis (replaces MRI evidence of enthesitis)

Distal interphalangeal joint disease

Sacroiliitis/spinal inflammation

Uncommon arthropathies (SAPHO, spondylodiscitis, arthritis mutilans, onchyo-pachydermo-periostitis, chronic multifocal recurrent osteomyelitis)

Dactylitis

Monoarthritis

Oligoarthritis (four or less swollen joints)

 

 

Criteria for psoriatic arthritis proposed by Vasey and Espinoza

 

Psoriatic arthritis is defined as criterion I plus one from either criterion II or III

 

Criterion I: Psoriatic skin or nail involvement

 

Criterion II: Peripheral pattern

 

(1) Pain and soft tissue swelling with or without limitation of movement of the distal interphalangeal joint for over four weeks

(2) Pain and soft tissue swelling with or without limitation of motion of the peripheral joints involved in an asymmetrical peripheral pattern for over four weeks. This includes a sausage digit

(3) Symmetrical peripheral arthritis for over four weeks, in the absence of rheumatoid factor or subcutaneous nodules

(4) Pencil in cup deformity, whittling of terminal phalanges, fluffy periostitis and bony ankylosis

 

Criterion III: Central pattern

 

(1) Spinal pain and stiffness with the restriction of motion present for over four weeks

(2) Grade 2 symmetric sacroiliitis according to the New York criteria

(3) Grade 3 or 4 unilateral sacroiliitis