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Inflammatory Joint Manifestations are Prevalent in Psoriasis: Prevalence Study of Joint and Axial Involvement in Psoriatic Patients, and Evaluation of a Psoriatic and Arthritic Questionnaire
GERD-MARIE ALENIUS, BERNDT STENBERG, HANS STENLUND, MAGNUS LUNDBLAD, and SOLBRITT RANTAPÄÄ DAHLQVIST
ABSTRACT.
Methods. An evaluation of a questionnaire (PAQ) in a hospital- and community-based population of 276 psoriatic patients, and clinical, radiological, and laboratory examination of the 202 patients answering the questionnaire and willing to participate in the subsequent study. Results. Ninety-seven patients (48%) were identified as having, or having had, inflammatory manifestations (peripheral arthritis, axial disease, uSpA, and enthesopathies). Sixty-seven patients (33%) had peripheral arthritis and/or axial disease, 30 of whom had not previously been diagnosed. A total PAQ score of 4 out of 8 was the best cutoff value detecting arthritis with a sensitivity of 60% and a specificity of 62.2%. A positive answer to the question "Have you ever thought you might have arthritis?" in combination with morning stiffness in peripheral joints for at least 60 min, had a sensitivity of 30% and a specificity of 91.1% and was significantly associated with peripheral arthritis and/or axial disease in multiple logistic regression analysis. Conclusion. We found a high prevalence of inflammatory joint/axial disease in this group of psoriatic patients. Almost half the patients with peripheral arthritis and/or axial disease had not previously been diagnosed. The PAQ did not, either as a total score or by combining questions, discriminate for arthritis in this population with psoriasis. (J Rheumatol 2002;29:2577-82) Key Indexing Terms:
PSORIATIC ARTHRITIS
From Divisions of Rheumatology, Dermatology and Venereology, and Epidemiology, Department of Public Health and Clinical Medicine, and Diagnostic Radiology, Department of Radiation Sciences, University Hospital, Umeå, Sweden. Supported by grants from The Swedish Psoriasis Association and the Medical Faculty of the University of Umeå and the King Gustaf V 80-year Foundation. G-M. Alenius, MD; S. Rantapää Dahlqvist, MD, PhD, Rheumatology; B. Stenberg MD, PhD, Dermatology and Venereology, and Epidemiology; H. Stenlund, PhD, Epidemiology, Department of Public Health and Clinical Medicine; M. Lundblad MD, Diagnostic Radiology, Department of Radiation Sciences, University Hospital. Address reprint requests to Dr. S. Rantapää Dahlqvist, Rheumatology, Department of Public Health and Clinical Medicine, University Hospital, S-901 85 Umeå, Sweden. Submitted February 4, 2002; revision accepted June 11, 2002. |