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Psoriatic Arthritis Self-Assessment

If you are experiencing symptoms of psoriatic arthritis or have been diagnosed with the disease, you may find the following psoriatic arthritis self-assessment questions helpful. They can help you identify areas of your care that might benefit from a discussion with your doctor or medical specialist.

Answer each question below, and then click “Next.” Once you complete all the answers, clicking the “Next” button will take you to a page with your results. You can print the results page to discuss with your doctor. Information collected in the self-assessment will be pooled for overall analysis and will not be linked back to any personally identifiable information. All information you provide below is optional.

Are you taking any medication on a regular basis for your psoriatic arthritis? (please check all that apply)

No
Topical ointments/creams
Motrin®*, Aleve®*, or other
      over-the-counter pain relievers
Celebrex®* (celecoxib)
TrexallTM* (methotrexate)
 Sulfasalazine
Arava®* (leflunomide)
Enbrel®* (etanercept)
Humira®*
Other

Are you getting the relief you want from your medication?

No Rarely Occasionally Frequently

Even with you current medication, are you experiencing painful, stiff, and swollen joints?

No Rarely Occasionally Frequently

Has your joint pain increased in severity since you began your current treatment?

Yes No

Has the number of joints affected by arthritis pain increased since you began your current treatment?

Yes No

In spite of current therapy, are you experiencing swollen, "sausage" fingers and toes?

No Rarely Occasionally Frequently

Even with your current medication, are you still experiencing painful Achilles tendon?

No Rarely Occasionally Frequently

Even with your current medication, are you still experiencing skin lesions with scaly flakes?

No Rarely Occasionally Frequently

Do your skin and joint symptoms make you feel embarrassed or depressed?

No Rarely Occasionally Frequently

Describe your level of pain in doing the following tasks on a scale of 1 to 10 (1=less, 10=more).

1 2 3 4 5 6 7 8 9 10
Dressing yourself:
Gripping a cup:
Shampooing your hair:
Climbing a few stairs:
Getting in and out of bed:

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