Screening for arthritis in people with psoriasis

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Many people with psoriasis have psoriatic arthritis and don’t know it.

A recent study (ref 1) found that up about 1 in 6 people have psoriatic arthritis but about a third of these people don’t know that they have it!

There are 2 possible reasons why there are people with undiagnosed psoriatic arthritis:

1. Some people never see their doctor to explain unusual symptoms.
2. Some doctors may not recognised psoriatic arthritis because it is hard to diagnose without a complete assessment by a specialist.

People with psoriasis may also have abnormalities in their bones and joints without knowing it. These abnormalities may be the early signs of arthritis. Sometimes the only way to see these abnormalities is with an ultrasound scan. There has been a lot of progress in the treatment of arthritis recently, and the earlier that treatment starts, the more chance it has of being successful in halting the disease.

So, what can be done to improve the diagnosis of psoriatic arthritis?

Education is the most important step to improving the identification of people with psoriatic arthritis. Both doctors and people with psoriasis need to be aware of the symptoms that should alert them to the need for further investigations, and a simple screening questionnaire would be an invaluable tool for doctors who do not specialise in psoriatic arthritis.

Not all aches and pains will be due to arthritis, but if a simple questionnaire can lead to the early diagnosis of those who have psoriatic arthritis, then early treatment can lead to a significant improvement in their lives.

Over the last 2 years, 3 such questionnaires have been developed, two in the United States, and one in the UK, but we don’t know which is best.

To answer this question, the University of Leeds is sponsoring a study in 2010 in 5 UK centres;


This study will ask people with psoriasis attending dermatology departments to complete 3 questionnaires and undergo an examination by a bone and joint specialist (a rheumatologist ).

If you attend a dermatology department in one of these 5 centres you may be asked to take home some information to read about this study.

We would be delighted if you decide to take part. Your participation and contribution will help to decide which of the psoriatic arthritis screening questionnaire the best is for people in the UK.


1.Ibrahim G, Waxman R, Helliwell PS. The prevalence of psoriatic arthritis in people with psoriasis. Arthr Care & Res 2009; 61(10):1373-1378.

About the author:

Philip Helliwell is currently Senior Lecturer in Rheumatology at the University of Leeds, in the UK, and Honorary Consultant Rheumatologist for the Bradford Hospitals NHS Trust.

Previous appointments include: Member of NHS R&D Research Committee on Physical and Complex Disabilities, Member of the Executive Council, Centre for Biomechanics and Medical Engineering; Treasurer and Member of Executive Committee, Society for Back Pain Research; Member of Education Committee, Arthritis Research Campaign; and Editor for the ARC Patient Information Leaflets and Convener Publications Working Group. His main research interest is in clinical features and classification of psoriatic arthritis. He was a founding member of the GRAPPA group in 2003 and served on the Executive Committee until 2008. He was the PI of the CASPAR study and is now leading the GRAPPA composite measure exercise in preparation for OMERACT 2010.

Between 1997 and 2000, Dr Helliwell was a Member of the Heberden Committee, at the British Society for Rheumatology where he was involved in research, training and educational matters. He was also a Member of Council at the British Society for Rheumatology.

Dr Helliwell is also a referee for MRC, EPSRC, ARC and several European and North American Journals.

Note from editor:

Get involved: If you are interested in the study and attend one of dermatology centres mentioned above, ask your dermatologist about taking part at your next appointment, or look out for details at the centre.