The American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR) have updated the criteria for the diagnosis of rheumatoid arthritis (RA). The new criteria will allow for earlier therapy which will hopefully improve outcomes.
Parameters:
(1) joint involvement
(2) serologic testing (rheumatoid factor and anti-citrullinated protein antibody)
(3) duration of synovitis
(4) acute phase reactants (ESR or C-reactive protein)
|
Parameter |
Finding |
Points |
|
medium to large joints |
0 to 1 involved |
0 |
|
|
>= 2 involved |
1 |
|
small joints |
0 involved |
0 |
|
|
1 to 3 involved |
2 |
|
|
4 to 10 involved |
3 |
|
|
> 10 involved |
5 |
|
rheumatoid factor |
normal |
0 |
|
|
1.1 to 3 times upper limit of normal (ULN) |
2 |
|
|
> 3 times ULN |
3 |
|
anticitrullinated protein antibody |
normal |
0 |
|
|
1.1 to 3 times upper limit of normal (ULN) |
2 |
|
|
> 3 times ULN |
3 |
|
duration of synovitis |
< 6 weeks |
0 |
|
|
6 or more weeks |
1 |
|
acute phase reactants |
both CRP and ESR are normal |
0 |
|
|
either CRP or ESR abnormal |
1 |
score =
= MAX(points for medium to large joints, points for small joints) + MAX(points for RF, points for anti-citrullinated protein antibody) + (points for duration of synovitis) + (points for acute phase reactants)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >= 6 indicates definite RA.
• A score < 3 indicates that RA is unlikely.
Purpose: To evaluate a patient for rheumatoid arthritis using the updated ACR/EULAR criteria.
Specialty: Immunology/Rheumatology
Objective: laboratory tests, severity, prognosis, stage, disease progression, prevention
ICD-10: M05, M06, M48.0,
