What Screening Tools Are Used to Help Diagnose Psoriatic Arthritis?
Reviewed by: HU Medical Review Board | Last reviewed: August 2022 | Last updated: March 2023
There are several questionnaires used to screen patients for psoriatic arthritis (PsA). These screening tools can provide insight into a person’s symptoms, which may lead to a PsA diagnosis.1
Dermatologists often use PsA screening tools to determine whether a person with psoriasis has PsA symptoms. They can then refer them to a rheumatologist, a doctor who specializes in the diagnosis and treatment of joint diseases like PsA.1
How can screening tools help a PsA diagnosis?
PsA screening tools are not diagnostic tools. They cannot be used on their own to make a PsA diagnosis. But what they can do is prompt a person to look closer at whether their symptoms are signs of PsA or something else.1
PsA screening tools ask questions about symptoms including:1,2
- Joint pain
- Joint swelling
- Skin psoriasis
- Nail changes – nail pitting, detachment of the nail from the nail bed, and discoloration
- Sausage-like swelling of the fingers or toes (dactylitis)
Some screening tools use mannequins, images, and other visual aids. These make it easier for people to point to which joints are affected and describe their other symptoms.1
Types of PsA screening tools
Screening tools help capture a person’s perspective of their overall health. They do not require any special medical equipment, since they are usually a list of questions. They are easy to complete and do not typically require a visit to your doctor.1
Read on to learn more about the most common PsA screening tools.
Early Arthritis for Psoriatic Patients (EARP) questionnaire
The EARP questionnaire is a rapid screening method for identifying PsA in people who already have psoriasis. It has 10 questions. It was designed to be user friendly and easy to give.1
Psoriatic Arthritis Screening and Evaluation (PASE) tool
The PASE questionnaire was designed to help dermatologists identify people with psoriasis who should be referred to a rheumatologist. The PASE tool has 15 questions. Seven of the questions assess symptoms, while the other 8 assess physical function.1
Scoring is done by adding the numbers. Those with higher scores are more likely to have PsA. The PASE tool has shown to be effective in distinguishing between PsA and osteoarthritis. It can also help doctors tell the difference between severe and less severe types of PsA.1
Toronto Psoriatic Arthritis Screening (ToPAS)
A rheumatologist at the University of Toronto named Dr. Dafna Gladman was the first to use ToPAS. ToPAS uses pictures of skin psoriasis and asks questions about pain and stiffness in the joints and back. ToPAS is also designed to help recognize psoriasis, nail changes, and joint swelling.1
Psoriasis Epidemiology Screening Tool (PEST)
PEST is based on earlier screenings but added new questions. A mannequin was also added to the screening assessment so that people can point out areas of soreness and pain.1
Which screening tool is best?
All 4 screening tools – EARP, PACE, ToPAS, and PEST – can help dermatologists identify people who may benefit from a rheumatologist visit. But some tools work better than others.1
Researchers have compared these screening tools in clinical trials. In 2019, researchers found that EARP was the most accurate screening tool when compared with the rest.1
Screening is important for early detection
No universal screening tool for PsA exists yet. And researchers agree that more studies are needed to understand how they can best be used. But screening tools, while not perfect, are an important part of early detection.