Hadar Gavra1, Irit Tirosh2,3, Shiri Spielman2,3, Shoshana Greenberger3,4, Gil Amarylio5,6, Liora Harel5,6, Dan Ben-Amitai6,7, Emily Avitan-Hersh8,9, Butbul Aviel Yonatan10,11. 1. The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. 2. Pediatric Rheumatology Service, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel. 3. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 4. Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Israel. 5. Pediatric Rheumatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. 6. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 7. Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. 8. Department of Dermatology, Rambam Health Care Campus, Haifa, Israel. 9. Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, 31096, Haifa, Israel. 10. The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. yonatanbutbul@gmail.com. 11. Pediatric Rheumatology Service, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Efron Street 1, Bat-Galim, 31096, Haifa, Israel. yonatanbutbul@gmail.com.
Abstract
OBJECTIVE: Juvenile psoriatic arthritis (JPsA) is a severe inflammatory arthritis, which is associated with psoriasis in most cases. While there are few validated screening tools for diagnosis of arthritis for adult patients with psoriasis, those screening tools were never evaluated in children. The aims of this study were to evaluate two screening tools among pediatric patients with psoriasis. METHODS: Thirty-nine patients with the diagnosis of psoriasis completed two screening questionnaires: The Psoriasis Epidemiology Screening Tool (PEST) questionnaire and the new Early Arthritis for Psoriatic Patients (EARP) questionnaire. All patients were evaluated by a rheumatologist for the diagnosis of JPsA, and the accuracy of the two questionnaires was compared. RESULTS: The 4/39 (10.1%) patients diagnosed with JPsA had a PEST questionnaire score of ≥ 3, compared to a median PEST score of the patients without the diagnosis of JPsA of 0 (0-2). Thus, both the sensitivity and specificity of the PEST in diagnosing JPsA were 100%. For the EARP questionnaire, 8/39 patients had a screening questionnaire score of ≥ 3, suggestive of JPsA, four were true positive, and four false positive. Thus, the sensitivity and specificity of EARP in diagnosing JPsA were 100% and 89%, respectively. CONCLUSION: Both the PEST and EARP questionnaires were easy to use and had high sensitivity for the diagnosis of JPsA in the pediatric population with psoriasis. The PEST questionnaire had a higher specificity than the EARP. KEY POINTS: • EARP and PEST are good screening tools for diagnosis of arthritis in pediatric population with psoriasis.
OBJECTIVE: Juvenile psoriatic arthritis (JPsA) is a severe inflammatory arthritis, which is associated with psoriasis in most cases. While there are few validated screening tools for diagnosis of arthritis for adult patients with psoriasis, those screening tools were never evaluated in children. The aims of this study were to evaluate two screening tools among pediatric patients with psoriasis. METHODS: Thirty-nine patients with the diagnosis of psoriasis completed two screening questionnaires: The Psoriasis Epidemiology Screening Tool (PEST) questionnaire and the new Early Arthritis for Psoriatic Patients (EARP) questionnaire. All patients were evaluated by a rheumatologist for the diagnosis of JPsA, and the accuracy of the two questionnaires was compared. RESULTS: The 4/39 (10.1%) patients diagnosed with JPsA had a PEST questionnaire score of ≥ 3, compared to a median PEST score of the patients without the diagnosis of JPsA of 0 (0-2). Thus, both the sensitivity and specificity of the PEST in diagnosing JPsA were 100%. For the EARP questionnaire, 8/39 patients had a screening questionnaire score of ≥ 3, suggestive of JPsA, four were true positive, and four false positive. Thus, the sensitivity and specificity of EARP in diagnosing JPsA were 100% and 89%, respectively. CONCLUSION: Both the PEST and EARP questionnaires were easy to use and had high sensitivity for the diagnosis of JPsA in the pediatric population with psoriasis. The PEST questionnaire had a higher specificity than the EARP. KEY POINTS: • EARP and PEST are good screening tools for diagnosis of arthritis in pediatric population with psoriasis.
Authors: Megha M Tollefson; Cynthia S Crowson; Marian T McEvoy; Hilal Maradit Kremers Journal: J Am Acad Dermatol Date: 2009-12-05 Impact factor: 11.527
Authors: Maria Ekelund; Kristiina Aalto; Anders Fasth; Troels Herlin; Susan Nielsen; Ellen Nordal; Suvi Peltoniemi; Marite Rygg; Marek Zak; Lillemor Berntson Journal: Pediatr Rheumatol Online J Date: 2017-02-22 Impact factor: 3.054