By Dr Irwin Lim, Rheumatologist
In truth, I didn't know that these screening questionnaires existed until I decided to try and find something to make our local dermatologists more aware of psoriatic arthritis.
Actually, the dermatologists are aware of the existence of Psoriatic Arthritis. The problem is that I don't think many can usually pick up the manifestations of the disease unless severe and at the point it's in-your-face. They're just not trained in this manner so it's understandable.
In Sydney at least, dermatology appointments are short, much shorter than the standard rheumatology appointment. Time seems to be an expensive commodity. I'd wager not too many questions are asked about joint symptoms or back pain or tendon discomfort.
Dermatology clinics will of course have a pool of patients suffering with psoriasis because of the most visible manifestation, the rash. It's estimated that up to 30% of these patients will have psoriatic arthritis.
So, the challenge is how to screen this pool of patients as efficiently as possible to identify those who would benefit from referral to the only group of physicians trained to pick up this often difficult-to-make diagnosis (read Psoriatic Arthritis: it's easy to miss) - Rheumatologists.
I've collected some questionnaires that seem to be used in other parts of the world, or at least, in the centres where they were created:
There's another tool , the Psoriasis & Arthritis Screening Questionnaire (PASQ), that's now available as an app (iTunes link).
Do any of you have experience with any of these screening tools? Do you find that dermatologists or their dermatology nurses actually use such tools?
If you were to be given one to use, which would you choose? I'm leaning towards the PEST questionnaire, given it's short & simple.Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.