武漢市第三醫(yī)院皮膚科彭才智

　　已確定的炎性骨骼肌肉疾?。P(guān)節(jié)、脊柱或肌腱端）伴有如下至少3項(xiàng):

　　1. 銀屑?。?a)由合格健康專業(yè)人員確定目前存在銀屑病皮疹或頭皮疾病和/或 (b)從患者或合格健康專業(yè)人員獲得的銀屑病病史和/或(c)患者提供的其第1級(jí)或第2級(jí)親屬有銀屑病史。

　　2.指甲改變:目前查體發(fā)現(xiàn)有典型銀屑病指甲營(yíng)養(yǎng)不良，包括指甲剝離、凹陷和過(guò)度角化。

　　3.RF陰性。

　　4.指（趾）炎：(a)目前整個(gè)指（趾）腫脹和/或 (b)由合格健康醫(yī)學(xué)人員記錄的指（趾）炎史

　　5.放射線有關(guān)節(jié)鄰近新骨形成證據(jù): 手或足X線片上顯示關(guān)節(jié)間隙附近有模糊骨化（但排除骨贅形成）

　　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.