Bennett presented criteria for the diagnosis of psoriatic arthritis. These were based on the recommendations made by Wright and Moll.
Mandatory criteria - both of the following observed by a physician for >= 6 weeks:
(1) clinically apparent psoriasis affecting skin and/or nails
(2) pain and soft tissue swelling and/or limitation in motion in >= 1 joint observed by a physician
Supportive criteria:
(1) Pain and soft tissue swelling and/or limitation in motion in >= 1 joint observed by a physician.
(2) The presence of an inflammatory arthritis in a distal interphalangeal joint. Excluded if Heberden's or Bouchard's nodes.
(3) The presence of "sausage" fingers or toes.
(4) An asymmetrical distribution of the arthritis in the hands and feet
(5) Absence of subcutaneous nodules
(6) A negative test for rheumatoid factor in the serum
(7) An inflammatory synovial fluid with (a) a normal or increased C3 or C4 level; (b) negative for infection; (c) negative for monosodium urate; and (d) negative for calcium pyrophosphate
(8) A synovial biopsy showing (a) hypertrophy of the synovial lining' (b) a predominantly mononuclear cell infiltration; (c) absence of granuloma formation; (d) absence of tumor
(9) Peripheral radiographs showing erosive arthritis of small joints with a relative lack of osteoporosis. Excluded if erosive osteoarthritis is identified.
(10) Axial radiographs showing one or more of the following: (a) sacroiliitis; (b) syndesmorphytes (sometimes atypical); (c) paravertebral ossification
where:
• The first supportive criteria differs from the second manditory finding in that a period of time is not specified.
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Mandatory Criteria
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Supportive Criteria
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Interpretation
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|
present
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>= 6
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definite
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|
present
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4 or 5
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probable
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|
present
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2 or 3
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possible
|
|
mandatory absent OR 0 or 1 supportive criteria present
|
negative
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