Rheumatoid arthritis classification

Jump to navigation Jump to search

Rheumatoid arthritis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Rheumatoid arthritis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgical Therapy

Primary prevention

Secondary prevention

Future or Investigational Therapies

Case Studies

Case #1

Rheumatoid arthritis classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Rheumatoid arthritis classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

National Guidelines Clearinghouse

NICE Guidance

FDA on Rheumatoid arthritis classification

CDC on Rheumatoid arthritis classification

Rheumatoid arthritis classification in the news

Blogs onRheumatoid arthritis classification

Directions to Hospitals Treating Rheumatoid arthritis

Risk calculators and risk factors for Rheumatoid arthritis classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

There is no established system for the classification of rheumatoid arthritis. Depending on the presentation of rheumatoid arthritis, it is classified into typical classic rheumatoid arthritis and palindromic rheumatism. The classification criterion for the diagnosis of rheumatoid arthritis according to American College of Rheumatology, uses 4 parameters including joint involvement, serology, duration of symptoms, and acute phase reactants. If the score is more than 6 according to this criteria, the disease is classified as definite rheumatoid arthritis.

Classification

There is no established system for the classification of rheumatoid arthritis. Depending on the presentation of rheumatoid arthritis, it may be classified as follows:

The 2010 American College of Rheumatology classification criteria for diagnosis of rheumatoid arthritis:[3][4]

The 2010 American College of Rheumatology criteria rates various variables on a scale from 0-10 points. The points are assigned in four separate domains of signs and symptoms:

1) Joint involvement

2) Serology

3) Duration of symptoms

4) Acute phase reactants

Patients are classified as definite RA if the score of 6 or more points is seen according to the following criteria. The details of the scoring criteria are discussed below:

The 2010 American College of Rheumatology classification criteria for rheumatoid arthritis.
Domains Description Number Score
Joint Involvement Median-large joint* 2-10 1
1-3 2
Small joints** 4-10 3
>10*** 5
Serology No positive for either RF or anti-CCP 0
At least one of these test positive at the high titer 2
At least one of these test positive at low titer 3
Duration of synovitis +/> six weeks 1
Acute phase reactants Neither CRP or ESR is abnormal 0
Abnormal CRP or ESR 1

*Distal interphalangeal,1st carpometacarpal and 1st tarsometatarsal joints are excluded from the assessment. Shoulder, elbow, knee, and ankle joints are included.

** Small joints refer to metacarpophalangeal, proximal interphalangeal, second through 5th metatarsophalangeal, thumb interphalangeal and wrist joints

*** In this category, at least one of the involved joints must be a small joint; the other joints can include any combination of large additional small joint joins as well as other such as temporomandibular, acromioclavicular, sternoclavicular

References

  1. Fleming A, Crown JM, Corbett M (August 1976). "Early rheumatoid disease. I. Onset". Ann. Rheum. Dis. 35 (4): 357–60. PMC 1007396. PMID 970994.
  2. Jacoby RK, Jayson MI, Cosh JA (April 1973). "Onset, early stages, and prognosis of rheumatoid arthritis: a clinical study of 100 patients with 11-year follow-up". Br Med J. 2 (5858): 96–100. PMC 1589106. PMID 4700332.
  3. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (September 2010). "2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative". Arthritis Rheum. 62 (9): 2569–81. doi:10.1002/art.27584. PMID 20872595.
  4. Maksymowych WP, Suarez-Almazor ME, Buenviaje H, Cooper BL, Degeus C, Thompson M, Russell AS (November 2002). "HLA and cytokine gene polymorphisms in relation to occurrence of palindromic rheumatism and its progression to rheumatoid arthritis". J. Rheumatol. 29 (11): 2319–26. PMID 12415587.

Template:WH Template:WS