Aim Because of doubts in early clinical assessment and full documentation o
f all various cases of psoriatic arthritis outside of rheumatologic centres
a clinical study in a dermatologic department of a rehabilitation clinic w
as performed. Methods: 148 patients between 1996 and 1999 were interviewed
and examined clinically. 27 (18.2%) of them had osseous joint processes pro
ved by X-ray (severe cases). 90 (60.8%) patients had no radiologic changes
but a positive history of joint pain (mild cases). 31 (21%) patients had no
ne of the problems (Control group). Blood specimens were taken in order to
reveal inflammations (ESR. CRP, RF, ASL, uric acid, and leucocytes). Exclus
ion criteria were other arthritides, multiple osteoarthritis and consolidat
ed fractures of joints. The groups were compared together. Results: Whereas
palpable joint crepitations did not turn out as a reliable specific sign,
pressure pain on acromioclavicular joints and MTP joints, impingement signs
of the shoulders, deformities of toes and flexor tendon swellings of the h
and were usable tools in diagnosing a severe psoriatic arthritis in this st
udy. The ESR, ASL, CRP, and uric acid were elevated significantly more ofte
n in severe than in mild cases. Moreover, the time period between the first
onset of skin lesions and joint pain was shorter in severe cases than in m
ild cases (9.86 vs 13.8 years). Conclusion: The diagnostic relevance of cri
teria, for example of the well-known European Spondylarthropathy Group (ESS
G), may be improved by new early screening criteria.