Fournie et al developed a score for the diagnosis of psoriatic arthritis. The authors are from Purpan Teaching Hospital in Toulouse, France.
Parameters:
(1) psoriasis
(2) family history of psoriasis
(3) arthritis in distal interphalangeal joint
(4) monoarthritis or asymmetrical oligoarthritis
(5) pain in buttock, heel, anterior chest wall or entheses
(6) radiological criteria (see below)
(7) human leukocyte antigen (HLA)
(8) rheumatoid factor
Radiological criteria:
(1) erosion of distal interphalangeal joint
(2) osteolysis
(3) ankylosis
(4) juxta-articular periostitis
(5) phalangeal tuft resorption
Parameter |
Finding |
Points |
psoriasis and family history |
psoriasis antedating joint symptom onset |
6 |
|
psoriasis concomitant with joint symptom onset |
6 |
|
psoriasis post-dating symptom onset |
3 |
|
family history of psoriasis |
3 |
|
none of the above |
0 |
arthritis in distal interphalangeal joint |
absent |
0 |
|
present |
3 |
arthritis |
monoarthritis |
1 |
|
asymmetrical oligoarthritis |
1 |
|
symmetrical oligoarthritis |
0 |
|
polyarthritis |
0 |
pain |
pain in buttock, heel or spontaneous anterior chest wall |
2 |
|
diffuse inflammatory pain in entheses |
2 |
|
other |
0 |
|
no pain |
0 |
radiological criteria |
none |
0 |
|
one or more present |
5 |
HLA |
B16 or B17 |
6 |
|
neither |
0 |
rheumatoid factor |
present |
0 |
|
absent |
4 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 27
• A score >= 11 is diagnostic for psoriatic arthritis.
Purpose: To evaluate a patient for psoriatic arthritis using the criteria of Fournie et al.
Specialty: Immunology/Rheumatology
Objective: clinical diagnosis, including family history for genetics, laboratory tests
ICD-10: L40.5, M07, M09.0,