New teaching tool could help doctors screen for PsA



A new teaching tool based on the acronym mnemonic PSA may help doctors to screen for psoriatic arthritis in patients with psoriasis or a strong family history of it.

The tool tells physicians to ask patients whether they are experiencing core features of psoriatic arthritis (PsA). Such features are tied to the acronym PSA. P stands for pain in the joints, S stands for stiffness more than 30 minutes after a period of inactivity and for sausage digits, and A represents axial spine involvement or back pain associated with stiffness that improves with activity. If patients with psoriasis and/or a strong family history of psoriasis say they are experiencing at least two of those features, then they “would have a higher than average chance of a PsA diagnosis,” according to Jeffrey M. Cohen and his colleagues.

Benefits of the tool include its ease of use and short administration time; it also covers “the core domains” of the disease, just like many of the current PsA screening tools.

The tool is limited, however, because it is unlikely to be as specific as the longer PsA screening instruments and it calls for questioning patients about features of PsA that are also features of other pathologies. Additionally, the tool is more specific to diagnosing seronegative peripheral and axial spondyloarthritides than inflammatory arthritis. It also is useful for distinguishing between noninflammatory arthritis and inflammatory arthritis.

“We feel this teaching tool, while not specific for PsA, will help the nonrheumatologist begin to differentiate inflammatory from noninflammatory musculoskeletal pain and therefore prompt an appropriate referral for work-up,” the researchers wrote.

Read the full paper in the Journal of the American Academy of Dermatology (doi:10.1016/j.jaad.2014.12.008).

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