Rheumatoid arthritis: diagnosis
NICE have stated that clinical diagnosis is more important than criteria such as those defined by the American College of Rheumatology.
2010 American College of Rheumatology criteria
Target population. Patients who
Classification criteria for rheumatoid arthritis (add score of categories A-D;
a score of 6/10 is needed definite rheumatoid arthritis)
Key
2010 American College of Rheumatology criteria
Target population. Patients who
- 1) have at least 1 joint with definite clinical synovitis
- 2) with the synovitis not better explained by another disease
Classification criteria for rheumatoid arthritis (add score of categories A-D;
a score of 6/10 is needed definite rheumatoid arthritis)
Key
- RF = rheumatoid factor
- ACPA = anti-cyclic citrullinated peptide antibody
| Factor | Scoring | |
|---|---|---|
| A. Joint involvement | ||
| 1 large joint | 0 | |
| 2 - 10 large joints | 1 | |
| 1 - 3 small joints (with or without involvement of large joints) | 2 | |
| 4 - 10 small joints (with or without involvement of large joints) | 3 | |
| 10 joints (at least 1 small joint) | 5 | |
| B. Serology (at least 1 test result is needed for classification) | ||
| Negative RF and negative ACPA | 0 | |
| Low-positive RF or low-positive ACPA | 2 | |
| High-positive RF or high-positive ACPA | 3 | |
| C. Acute-phase reactants (at least 1 test result is needed for classification) | ||
| Normal CRP and normal ESR | 0 | |
| Abnormal CRP or abnormal ESR | 1 | |
| D. Duration of symptoms | ||
| < 6 weeks | 0 | |
| > 6 weeks | 1 |