Screening Tools for Spondyloarthritis in Patients With Psoriasis, Uveitis, and Inflammatory Bowel Disease: A Scoping Review

Abstract

ObjectiveExtra‐musculoskeletal manifestations of Spondyloarthritis (SpA) may precede the development of articular features. Patients seen in ophthalmology, dermatology, and gastroenterology clinics with uveitis, psoriasis, or inflammatory bowel disease (IBD) may have undiagnosed SpA. We set out to identify and evaluate screening tools for SpA in patients with psoriasis, uveitis, and IBD and determine factors that influence the performance of these instruments.MethodsScoping review following PRISMA guidelines. PubMed, EMBASE, and Web of Science were searched from inception to January 2022.ResultsWe identified 13 screening tools for PsA, 2 SpA screening tools in uveitis, and 3 SpA screening tools in IBD. All screening tools were patient‐oriented questionnaires except for the Dublin Uveitis Evaluation Tool, a physician‐applied algorithm. The questionnaires varied in length, scoring method, cut‐off score, and spectrum of included SpA features. Average completion time was <5 minutes. Across the three patient populations, the sensitivities and specificities of these screening tools were comparable in the primary validation cohorts. Sensitivities and specificities were generally lower in secondary validation studies, with marked variability between cohorts.ConclusionOur results highlight the heterogeneity and limitations of existing SpA screening tools. While these tools show promise for use within a specific target population, none are generalizable to all patients with extra‐musculoskeletal manifestations at risk for SpA. Future studies should explore the utility of a generic patient‐oriented SpA screening tool that can be applied to patients with psoriasis, uveitis, or IBD, is easy to use and comprehend, and captures all clinical domains of SpA.