武汉市第三医院皮肤科彭才智

　　已确定的炎性骨骼肌肉疾病（关节、脊柱或肌腱端）伴有如下至少3项:

　　1. 银屑病：(a)由合格健康专业人员确定目前存在银屑病皮疹或头皮疾病和/或 (b)从患者或合格健康专业人员获得的银屑病病史和/或(c)患者提供的其第1级或第2级亲属有银屑病史。

　　2.指甲改变:目前查体发现有典型银屑病指甲营养不良，包括指甲剥离、凹陷和过度角化。

　　3.RF阴性。

　　4.指（趾）炎：(a)目前整个指（趾）肿胀和/或 (b)由合格健康医学人员记录的指（趾）炎史

　　5.放射线有关节邻近新骨形成证据: 手或足X线片上显示关节间隙附近有模糊骨化（但排除骨赘形成）

　　附原文：CASPAR Diagnostic Criteria of PsA：

　　Established inflammatory musculoskeletal disease(joint, spine or entheseal) with three or more of the following:

　　1. Psoriasis: (a) current psoriatic skin or scalp disease currently present, as judged by a qualified health professional and/or (b) a history of psoriasis that may be obtained from patient, or qualified health professional and/or (c) a history of psoriasis in a first or second degree relative according to patient report.

　　2. Nail changes: typical psoriatic nail dystrophy, including onycholysis, pitting, and hyperkeratosis observed on current physical examination.

　　3. Negative test for RF.

　　4. Dactylitis (a) current swelling of an entire digit and/or (b) a history of dactylitis recorded by a qualified health professional.

　　5. Radiological evidence of juxta-articular new bone formation: Ill-defined ossification near joint margin (but excluding osteophyte formation) on plain radiographs of hand or foot.

　　Criteria yield specificity 98.7%,  sensitivity 91.4%

　　引自：Taylor W, Gladman D, Helliwell P, et al. Classification criteria for psoriatic arthritis: development of new criteria from a large international study. Arthritis Rheum. 2006,54:2665-73.