The New RA Criteria 2010

Patients are definitively diagnosed with RA if they score 6 or more points according to the following criteria

Domain: Joint involvement

– 1 large joint                                                                                              (0 points)

– 2-10 large joints                                                                                      (1 point )          

– 1-3 small joints                                                                                       (2 points)          

– 4-10 small joints                                                                                     (3 points)                              

– More than 10  joints (including at least one small joint)                 (5 points)          

Domain: Serology

– Not positive for either RF or anti–CCP                           (0 points)

– At least one of these tests are positive at low titer, ¹  (2 points)

– At least one test is positive at high titer,²                      (3 points)

Domain: Duration of synovitis

– Less than 6 weeks      (0 points)

– 6 weeks or longer        (1 point)

Domain: Acute phase reactants

– Neither C-reactive protein nor ESR is abnormal   (0 points)

– Abnormal CRP or abnormal ESR                             (1 point)

Note: Patients receive the highest point level they fulfill within each domain. For example, a patient with five small joints involved and four large joints involved scores 3 points.

¹ defined as more than the upper limit of normal but not higher than three times the upper limit of normal

² defined as more than three times the upper limit of normal

1988 revised ACR Criteria for diagnosis of rheumatoid arthritis

For a diagnosis of rheumatoid arthritis to be made at least 4 of the following criteria must be met.

Criteria 1-4 must be present for at least 6 weeks.

1. Morning stiffness > 1 hour.

2. Arthritis of 3 or more joint areas.

3. Arthritis of the hand joints.

4. Symmetrical arthritis.

5. Rheumatoid nodules.

6. Positive rheumatoid factor.

7. Radiological erosion or unequivocal periarticular osteoporosis on hand and wrist films.