This is the CASPAR entry requirement. Joint pain without confirmed inflammatory disease is not enough.
Skin, nail and joint symptoms
Psoriatic arthritis assessment.
Psoriatic arthritis can affect joints, the spine and tendon attachment sites. Psoriasis or nail changes may provide clues, but arthritis can sometimes appear before the skin disease.
CASPAR classification criteria. Complete this with your clinician using confirmed findings. These are classification criteria, not a self-diagnosis tool.
When to seek care: A painful red eye, light sensitivity or reduced vision needs urgent eye assessment. A new hot swollen joint, especially with fever, needs prompt review for infection.
These criteria use examination findings and specific test definitions. Do not infer them from symptoms alone; use not sure when a finding has not been assessed.
Choose one category only. Current psoriasis must be confirmed by a rheumatologist or dermatologist. Family history means a first- or second-degree relative.
Typical nail pitting, separation from the nail bed or thickening must be observed on examination.
A negative laboratory RF result earns this point. A positive RF does not by itself exclude psoriatic arthritis. Do not use a latex-only test.
A currently swollen whole finger/toe, or an earlier episode recorded by a rheumatologist. Current and past episodes count only once.
Juxta-articular new bone formation must be reported; ordinary osteophytes from osteoarthritis do not count.
Symptoms to discuss
- Swollen joints, morning stiffness, whole-digit swelling and heel or tendon-attachment pain.
- Scaly skin patches, nail pitting or separation; inflammatory back pain can occur.
Tests and care
- Skin, nail, joint and tendon examination, with blood tests to assess inflammation and alternatives.
- X-ray, ultrasound or MRI as appropriate; there is no single diagnostic blood test.
Early treatment can help protect joint function. Medicines are selected for the joints, skin and other conditions involved; they may include conventional or biologic disease-modifying treatment.
Classification is not diagnosis. A low score does not rule out disease. Do not arrange every listed test or start, stop or change medicines based on this result; your clinician decides what is needed.
Clinical references: Original CASPAR study · CASPAR criteria table · ACR patient guide: psoriatic arthritis