Rheumatoid arthritis classification

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

Overview

Classification

There is no established system for the classification of rheumatoid arthritis Depending on the presentation of rheumatoid arthritis, these are classified as follows:

  • Typical classic rheumatoid arthritis:

The 2010 American College of Rheumatology classification criteria for diagnosis of rheumatoid arthritis:[1]

The 2010 new criteria rates on a scale from 0-10 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 called as definite RA if they score 6 or more points according to the following criteria

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, ankle

@ 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. 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.

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