CASPAR Criteria for Psoriatic Arthritis

Diagnoses psoriatic arthritis based on presence of inflammatory articular disease and some clinical signs.

Refer to the text below the calculator for more information on the criteria used and the studies around the CASPAR definition.


The CASPAR criteria helps diagnose psoriatic arthritis based on presence of inflammatory articular disease and other clinical signs, symptoms and patient history.

The criteria consists in one mandatory criterion: “presence of inflammatory articular disease (joint, spine, or entheseal)” and 7 other criteria where a score of at least 3 out of 6 must be obtained for positive diagnosis.


The original study conducted by Taylor and Helliwell in 2005 concluded that the CASPAR criteria are simple and highly specific (0.987 versus 0.960) but less sensitive (0.914 versus 0.972) than the Vasey and Espinoza criteria.

CASPAR additional criteria (≥3 points for positive PsA diagnosis) Points
Current psoriasis: psoriatic skin or scalp disease present today, diagnosed by a rheumatologist or dermatologist 2
Personal history of psoriasis 1
Family history of psoriasis: psoriasis in a first- or second-degree relative 1
Typical psoriatic nail dystrophy (onycholysis, pitting, and hyperkeratosis on exam) 1
Rheumatoid factor negative (any method except latex; ELISA or nephelometry preferred) 1
Current dactylitis (swelling of an entire digit) or history of dactylitis recorded by a rheumatologist 1
Juxtaarticular new bone formation on hand or foot x-ray (ill-defined ossification near joint margins excluding osteophyte formation) 1

Required Criterion

1

Inflammatory articular disease (Joint, spine, or entheseal)

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About Caspar Criteria

The CASPAR criteria diagnoses psoriatic arthritis based on presence of inflammatory articular disease and other clinical signs, symptoms and patient history.

The criteria consists in one mandatory criterion: “presence of inflammatory articular disease (joint, spine, or entheseal)” and 7 additional criteria (each scored independently) where a sum of scores of at least 3 out of 6 must be obtained for positive diagnosis.

CASPAR additional criteria (≥3 points for positive PsA diagnosis) Points
Current psoriasis: psoriatic skin or scalp disease present today, diagnosed by a rheumatologist or dermatologist 2
Personal history of psoriasis 1
Family history of psoriasis: psoriasis in a first- or second-degree relative 1
Typical psoriatic nail dystrophy (onycholysis, pitting, and hyperkeratosis on exam) 1
Rheumatoid factor negative (any method except latex; ELISA or nephelometry preferred) 1
Current dactylitis (swelling of an entire digit) or history of dactylitis recorded by a rheumatologist 1
Juxtaarticular new bone formation on hand or foot x-ray (ill-defined ossification near joint margins excluding osteophyte formation) 1
 

Original study

In 2005, Taylor and Helliwell set out to compare the accuracy of existing classification criteria for the diagnosis of psoriatic arthritis (PsA) and to also develop new criteria from observed data.

Data from patients with PsA and other inflammatory arthropathies was analysed and subjects classified based on the new 7 criteria. Data were collected on 588 cases and 536 controls with rheumatoid arthritis, ankylosing spondylitis, undifferentiated arthritis, connective tissue disorders and other diseases.

Sensitivity and specificity were compared using conditional logistic regression analysis. In order to confirm the validity of clinical diagnosis latent class analysis was used for criteria accuracy.

The CASPAR (ClASsification criteria for Psoriatic ARthritis) criteria consisted of established inflammatory articular disease with at least 3 points from the additional criteria.

The original study conducted by Taylor and Helliwell in 2005 concluded that the CASPAR criteria are simple and highly specific (0.987 versus 0.960) but less sensitive (0.914 versus 0.972) than the Vasey and Espinoza criteria.

 

References

Original reference

Helliwell PS, Taylor WJ. Classification and diagnostic criteria for psoriatic arthritis. Ann Rheum Dis. 2005;64 Suppl 2:ii3-8.

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(8):2665-73.

Validation

Leung YY, Tam LS, Ho KW, et al. Evaluation of the CASPAR criteria for psoriatic arthritis in the Chinese population. Rheumatology (Oxford). 2010;49(1):112-5.


Specialty: Dermatology

Objective: Diagnosis

No. Of Criteria: 6

Year Of Study: 2005

Published On: May 19, 2020

Last Checked: May 19, 2020

Next Review: May 19, 2025