Diagnosis of Rheumatoid Arthritis
Target population for this tool:
1) Patients with at least one joint with definite clinical synovitis (swelling).
2) Patients with symptoms not better explained by another disease.[html]
See also the Rheumatoid Arthritis Likelihood calculator at <a href="../../musculoskeletal/ra-likelihood/">http://www.soapnote.org/musculoskeletal/ra-likelihood/</a>[/html]
1. Joint involvement <-- [select name="Q1" value="One large joint (0 points)=0|Two to 10 large joints (1 point)=1|One to three small joints with or without involvement of large joints (2 points)=2|Four to 10 small joints with or without involvement of large joints (3 points)=3|More than 10 joints, with at least one small joint (5 points)=5"]
Joint involvement refers to any swollen or tender joint on examination, which may be confirmed by imaging evidence of synovitis. DIP, 1st CMP, and 1st MTP are excluded from assessment.
Large joints are shoulders, elbows, hips, knees, and ankles.
Small joints are MCPs, PIPs, 2nd to 5th MTPs, thumb IPs, and wrists.
2. Serology (at least one test result is needed for classification) <-- [select name="Q2" value="Negative RF and negative ACPA (0 points)=0|Low positive RF or low positive ACPA (2 points)=2|High positive RF or high positive ACPA (3 points)=3"]
RF = rheumatoid factor. ACPA = anti-citrullinated protein antibody
3. Acute phase reactants (at least one test result is needed for classification) <-- [select name="Q3" value="Normal CRP and normal ESR (0 points)=0|Abnormal CRP or abnormal ESR (1 point)=1"]
CRP = C-reactive protein. ESR = erythrocyte sedimentation rate.
4. Duration of symptoms <-- [select name="Q4" value="Less than 6 weeks (0 points)=0|6 or more weeks (1 point)=1"]
SCORE --> [calc memo="score" value="score1=(Q1)+(Q2)+(Q3)+(Q4)"]
RESULT --> [calc memo="interpretation" value="score2=(Q1)+(Q2)+(Q3)+(Q4);score2>5?'MEETS 2010 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Rheumatoid Arthritis':'DOES NOT MEET 2010 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Rheumatoid Arthritis'"]
[html]<hr>[/html][checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"][html]
reference: From the <a href="http://www.ncbi.nlm.nih.gov/pubmed/20699241">2010 American College of Rheumatology/European League Against Rheumatism Criteria</a>.[/html][/conditional]