Katie Lennon

A new teaching tool based on the acronym mnemonic PSA may help doctors to screen for psoriatic arthritis in patients with psoriasis or a strong family history of it.

The tool tells physicians to ask patients whether they are experiencing core features of psoriatic arthritis (PsA). Such features are tied to the acronym PSA. P stands for pain in the joints, S stands for stiffness more than 30 minutes after a period of inactivity and for sausage digits, and A represents axial spine involvement or back pain associated with stiffness that improves with activity. If patients with psoriasis and/or a strong family history of psoriasis say they are experiencing at least two of those features, then they “would have a higher than average chance of a PsA diagnosis,” according to Jeffrey M. Cohen and his colleagues.

Benefits of the tool include its ease of use and short administration time; it also covers “the core domains” of the disease, just like many of the current PsA screening tools.

The tool is limited, however, because it is unlikely to be as specific as the longer PsA screening instruments and it calls for questioning patients about features of PsA that are also features of other pathologies. Additionally, the tool is more specific to diagnosing seronegative peripheral and axial spondyloarthritides than inflammatory arthritis. It also is useful for distinguishing between noninflammatory arthritis and inflammatory arthritis.

“We feel this teaching tool, while not specific for PsA, will help the nonrheumatologist begin to differentiate inflammatory from noninflammatory musculoskeletal pain and therefore prompt an appropriate referral for work-up,” the researchers wrote.

Read the full paper in the Journal of the American Academy of Dermatology (doi:10.1016/j.jaad.2014.12.008).

A new teaching tool based on the acronym mnemonic PSA may help doctors to screen for psoriatic arthritis in patients with psoriasis or a strong family history of it.

The tool tells physicians to ask patients whether they are experiencing core features of psoriatic arthritis (PsA). Such features are tied to the acronym PSA. P stands for pain in the joints, S stands for stiffness more than 30 minutes after a period of inactivity and for sausage digits, and A represents axial spine involvement or back pain associated with stiffness that improves with activity. If patients with psoriasis and/or a strong family history of psoriasis say they are experiencing at least two of those features, then they “would have a higher than average chance of a PsA diagnosis,” according to Jeffrey M. Cohen and his colleagues.

Benefits of the tool include its ease of use and short administration time; it also covers “the core domains” of the disease, just like many of the current PsA screening tools.

The tool is limited, however, because it is unlikely to be as specific as the longer PsA screening instruments and it calls for questioning patients about features of PsA that are also features of other pathologies. Additionally, the tool is more specific to diagnosing seronegative peripheral and axial spondyloarthritides than inflammatory arthritis. It also is useful for distinguishing between noninflammatory arthritis and inflammatory arthritis.

“We feel this teaching tool, while not specific for PsA, will help the nonrheumatologist begin to differentiate inflammatory from noninflammatory musculoskeletal pain and therefore prompt an appropriate referral for work-up,” the researchers wrote.

Read the full paper in the Journal of the American Academy of Dermatology (doi:10.1016/j.jaad.2014.12.008).

A new teaching tool based on the acronym mnemonic PSA may help doctors to screen for psoriatic arthritis in patients with psoriasis or a strong family history of it.

The tool tells physicians to ask patients whether they are experiencing core features of psoriatic arthritis (PsA). Such features are tied to the acronym PSA. P stands for pain in the joints, S stands for stiffness more than 30 minutes after a period of inactivity and for sausage digits, and A represents axial spine involvement or back pain associated with stiffness that improves with activity. If patients with psoriasis and/or a strong family history of psoriasis say they are experiencing at least two of those features, then they “would have a higher than average chance of a PsA diagnosis,” according to Jeffrey M. Cohen and his colleagues.

Benefits of the tool include its ease of use and short administration time; it also covers “the core domains” of the disease, just like many of the current PsA screening tools.

The tool is limited, however, because it is unlikely to be as specific as the longer PsA screening instruments and it calls for questioning patients about features of PsA that are also features of other pathologies. Additionally, the tool is more specific to diagnosing seronegative peripheral and axial spondyloarthritides than inflammatory arthritis. It also is useful for distinguishing between noninflammatory arthritis and inflammatory arthritis.

“We feel this teaching tool, while not specific for PsA, will help the nonrheumatologist begin to differentiate inflammatory from noninflammatory musculoskeletal pain and therefore prompt an appropriate referral for work-up,” the researchers wrote.

Read the full paper in the Journal of the American Academy of Dermatology (doi:10.1016/j.jaad.2014.12.008).

Rheumatoid arthritis (RA) patients’ severity of morning stiffness and morning pain have stronger correlations with their disease’s activity than does the duration of their morning stiffness, according to an analysis of 350 patients who participated in a randomized, controlled trial.

During the 12-week study of patients with symptomatic RA despite treatment with disease-modifying antirheumatic drugs, 231 of the patients added delayed-release prednisone to their treatment and the remaining 119 patients took a placebo. The patients’ disease activity was measured with the ACR20, 28-joint Disease Activity Score (DAS28), and the Health Assessment Questionnaire-Disability Index, while Pearson correlations were used to determine relationships between patients’ responses to treatment and their disease activity.

The correlations between severity of morning stiffness or intensity of pain on waking and DAS28 or ACR20 ranged from 0.44 to 0.48 for the full study cohort. The weaker correlation between duration of morning stiffness and disease activity ranged from 0.24 to 0.28. The researchers also found a statistically significant 0.91 correlation between the severity of morning stiffness and intensity of morning pain.

“These findings suggest that severity and duration of morning stiffness may provide subtly different measures of RA and its impact on patients. The superior measurement characteristics of the severity of morning stiffness favor this as the preferred outcome measure,” wrote first author Dr. Maarten Boers and his colleagues.

Find the full study in Arthritis Care & Research (doi:10.1002/acr.22592).

Rheumatoid arthritis (RA) patients’ severity of morning stiffness and morning pain have stronger correlations with their disease’s activity than does the duration of their morning stiffness, according to an analysis of 350 patients who participated in a randomized, controlled trial.

During the 12-week study of patients with symptomatic RA despite treatment with disease-modifying antirheumatic drugs, 231 of the patients added delayed-release prednisone to their treatment and the remaining 119 patients took a placebo. The patients’ disease activity was measured with the ACR20, 28-joint Disease Activity Score (DAS28), and the Health Assessment Questionnaire-Disability Index, while Pearson correlations were used to determine relationships between patients’ responses to treatment and their disease activity.

The correlations between severity of morning stiffness or intensity of pain on waking and DAS28 or ACR20 ranged from 0.44 to 0.48 for the full study cohort. The weaker correlation between duration of morning stiffness and disease activity ranged from 0.24 to 0.28. The researchers also found a statistically significant 0.91 correlation between the severity of morning stiffness and intensity of morning pain.

“These findings suggest that severity and duration of morning stiffness may provide subtly different measures of RA and its impact on patients. The superior measurement characteristics of the severity of morning stiffness favor this as the preferred outcome measure,” wrote first author Dr. Maarten Boers and his colleagues.

Find the full study in Arthritis Care & Research (doi:10.1002/acr.22592).

Rheumatoid arthritis (RA) patients’ severity of morning stiffness and morning pain have stronger correlations with their disease’s activity than does the duration of their morning stiffness, according to an analysis of 350 patients who participated in a randomized, controlled trial.

During the 12-week study of patients with symptomatic RA despite treatment with disease-modifying antirheumatic drugs, 231 of the patients added delayed-release prednisone to their treatment and the remaining 119 patients took a placebo. The patients’ disease activity was measured with the ACR20, 28-joint Disease Activity Score (DAS28), and the Health Assessment Questionnaire-Disability Index, while Pearson correlations were used to determine relationships between patients’ responses to treatment and their disease activity.

The correlations between severity of morning stiffness or intensity of pain on waking and DAS28 or ACR20 ranged from 0.44 to 0.48 for the full study cohort. The weaker correlation between duration of morning stiffness and disease activity ranged from 0.24 to 0.28. The researchers also found a statistically significant 0.91 correlation between the severity of morning stiffness and intensity of morning pain.

“These findings suggest that severity and duration of morning stiffness may provide subtly different measures of RA and its impact on patients. The superior measurement characteristics of the severity of morning stiffness favor this as the preferred outcome measure,” wrote first author Dr. Maarten Boers and his colleagues.

Find the full study in Arthritis Care & Research (doi:10.1002/acr.22592).