Moll and Wright developed a clinical classification for patients with psoriatic arthritis.
|
Clinical Findings |
Group |
|---|---|
|
arthritis predominantly involves the distal interphalangeal (DIP) joints, with nail lesions |
classic |
|
rapidly destructive osteolysis of the phalanges and metacarpals (doigt en lorgnette, opera glass deformity); often associated with sacroiliitis |
arthritis mutilans |
|
similar to rheumatoid arthritis, but seronegative for rheumatoid factor (RF) |
symmetric polyarthritis |
|
involves a single joint, or asymmetric involvement of a few toes or fingers; may involve DIP, PIP or metatarsophalangeal joints; single joint involvement may be as a sausage digit |
asymmetric oligoarthritis |
|
ankylosing spondylitis and psoriatic arthritis |
predominant spondylitis (spondylarthropathy) |
|
Group |
Frequency |
|---|---|
|
classic |
5-17% |
|
arthritis mutilans |
5% |
|
symmetric polyarthritis |
15% |
|
asymmetric oligoarthritis |
70% |
|
predominant spondylitis |
5% |
Limitations:
• The sensitivity is low (61% according to Pitzalis and Pipitone). This is because several subsets of disease have been recognized since 1973, including asymmetric polyarthritis and enthesopathy.
• Groups may overlap, and patients may progress from one to another over time.
• Some patients with seronegative symmetric polyarthritis may become seropositive at some time during the course of the disease.
Purpose: To classify a patient with psoriatic arthritis using the clinical scheme of Moll and Wright.
Specialty: Immunology/Rheumatology
Objective: criteria for diagnosis, differential diagnosis and mimics, red flags
ICD-10: M07,
