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Table 161-1

The CASPAR (CLASSIFICATION CRITERIA FOR PSORIATIC ARTHRITIS) CRITERIAa

To meet the CASPAR criteria, a pt must have inflammatory articular disease (joint, spine, or entheseal) with ≥3 points from any of the following five categories:
  1. Evidence of current psoriasis,b, c a personal history of psoriasis, or a family history of psoriasisd
  2. Typical psoriatic nail dystrophye observed on current physical examination
  3. A negative test result for rheumatoid factor
  4. Either current dactylitisf or a history of dactylitis recorded by a rheumatologist
  5. Radiographic evidence of juxtaarticular new bone formationg in the hand or foot

aSpecificity of 99% and sensitivity of 91%.

bCurrent psoriasis is assigned 2 points; all other features are assigned 1 point.

cPsoriatic skin or scalp disease present at the time of examination, as judged by a rheumatologist or dermatologist.

dHistory of psoriasis in a first- or second-degree relative.

eOnycholysis, pitting, or hyperkeratosis.

fSwelling of an entire digit.

gIII-defined ossification near joint margins, excluding osteophyte formation.

Source: From Taylor W et al: Classification criteria for psoriatic arthritis. Development of new criteria from a large international study. Arthritis Rheum, 54:2665, 2006.