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PSA for PsA: A Mnemonic for Evaluating Psoriatic Arthritis Risk
Transcript:
Not all psoriasis is equal. There are some psoriasis manifestations which are more associated with risk of psoriatic arthritis than others. Somebody comes into your clinic and is not overweight, does not have severe psoriasis, does not have scalp, does not have nails... if they don't meet those risk factors, then you can safely say your risk of having PsA is lower than somebody who would have had these risk factors.
The simple mnemonic, you know, PSA is great. That's like the least that we can use to remember, P for pain. Ask the patients, do they have new onset joint pain or stiffness, which is morning stiffness or stiffness after periods of inactivity. So, asking a patient when you wake up in the morning, do you feel stiff in your joints, and are you stiff for more than 30 minutes? Within the S, you also have sausage digits or swelling of your digits. And the A in that mnemonic is for axial disease. And that's, you know, that lower back pain, that lower back stiffness.
We do know that time is of the essence when it comes to diagnosing psoriatic arthritis. Even a delay as little as 6 months results in irreversible joint damage, and you should consider psoriatic arthritis in every patient that has psoriasis that walks into your door. You do not have to have a swollen joint or a tender joint to make a diagnosis of PsA because, you know, PsA is very heterogeneous.
So, patients that have signs or symptoms that are suspicious for PSA, you know, should be evaluated. So, send them out to a rheumatologist if you don't feel comfortable.
References:
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