VIDEO: Early screening 'critical' in psoriatic arthritis

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

Of course, our at risk population are people with psoriasis or with family history of psoriasis. And then we look at red flags which were noticed in epidemiological studies. So diagnosis of psoriatic arthritis is clinical, which can present challenges because it's dependent on the expertise of the physician, their education. And I also think the length of the appointment. If you can only focus on one, two, three things during the appointment, it's going to be easily overlooked if they have risk factors in addition to joint pain.

Yes. As you mentioned, Dr. Orbi, I think it is just, in terms of screening for psoriatic arthritis in patients who have psoriasis is critical. It's critical because you want to diagnose the disease early, you want the patient to come and see a specialist, a rheumatologist early, and then you want to initiate treatment and to treat to target so that you have the optimal outcomes in that patient. The longer there is delay, and you and I have seen that Dr. Orbi, patients, sometimes the psoriasis is missed or sometimes they have psoriasis and now they have joint pains maybe assessed as something which is non-inflammatory. And so the patient goes on pain management and there's a delay which should not be there while the patient is actually suffering from pain and disability. So I would say that early screening and always keeping it in mind that if you have a patient with psoriasis and is coming to your clinic with joint complaints or muscular skeletal pain for the primary care provider, it is critical for them to consider the potential diagnosis of psoriatic arthritis. And then Dr. Orbi has already mentioned that for us as rheumatologists, we know that there are, I mean, of course we assess them for inflammatory joint disease which is much more peripheral arthritis. And then there are risk factors in a patient who has psoriasis that is very tightly associated with the development of psoriatic arthritis. So I think we as rheumatologists are well aware of those, the question is, again, partnering with our primary care providers in the community. So they recognize that if somebody's coming to them with significant nail disease and now it's developing wrist pain, that's a patient they need to think of referring sooner than later.

Absolutely. I think teaching about the red flags is very, very important. The screening questionnaires rely on those clinical items. The CASPAR classification is very clinical except for the rheumatoid factor and the radio graphs. So it's very accessible. I think it has to do a lot with awareness.