Ultrasound Plus Questionnaire Best Triage Strategy for Potential PsA

A recent study found that a combination of targeted musculoskeletal ultrasound and a screening questionnaire improved the triage of patients suspected of having psoriatic arthritis (PsA) in a rapid access clinic environment.

This prospective study included 203 patients with psoriasis, no PsA diagnosis, and musculoskeletal symptoms. All were assessed using 3 triage modalities: assessment by advanced practice physical therapist, targeted musculoskeletal ultrasound (MSK-US), and PsA screening questionnaire. The patients were also evaluated by a rheumatologist and categorized as either not PsA, possible PsA, or PsA. A 1-year follow-up was completed where the patient’s status was reassessed. For each triage modality, sensitivity and specificity were calculated individually, as well as for combinations.

Of the 203 patients, 8% were classified as having PsA, and 23.6% as possibly PsA. The highest sensitivity was demonstrated by MSK-US (89%), and the highest specificity by Psoriatic Arthritis Screening and Evaluation questionnaire (79%). At the 1-year follow-up, all patient-reported outcome measures had significantly improved.

Based upon sensitivity and specificity, the study authors wrote “combining MSK-US with a screening questionnaire for PsA improved the triage of patients with suspected PsA.”

—Allison Casey

Reference:
Sarabia S, Farrer C, Yeung J, et al. Comparative efficacy of different triage methods for psoriatic arthritis: Results from a prospective study in a rapid access clinic. Arthritis Care Res (Hoboken). Published online: February 5, 2021. DOI: 10.1002/acr.24570