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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anthony Gallo, B.S. [2]
Overview
The Jones criteria can be used to establish the diagnosis of rheumatic fever. They were first published in 1944 by T. Duckett Jones, MD and have been periodically revised by the American Heart Association in collaboration with other groups.[1][2]
Jones Criteria for the Diagnosis of Rheumatic Fever
Criteria for Definitive Rheumatic Fever
The Jones Criteria for definitive rheumatic fever require evidence of streptococcal infection: elevated or rising antistreptolysin O titre or DNAase and either:
- Two major criteria
OR
- One major and two minor criteria
Exceptions are chorea and indolent carditis, each of which by itself can indicate rheumatic fever.[3][4][5][1][2]
Criteria for the Rejection of Rheumatic Fever
- Firm alternate diagnosis to rheumatic fever
- Does not meet criteria below
Major criteria
- Polyarthritis: a temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards
- Carditis: inflammation of the heart muscle which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur
- Subcutaneous nodules: painless, firm collections of collagen fibers over bones or tendons, commonly presenting on the back of the wrist, the outside elbow, and the front of the knees
- Erythema marginatum: a long lasting rash that begins on the trunk or arms as macules and spreads outward to form a snake like ring while clearing in the middle, made worse with heat
- Sydenham's chorea (St. Vitus' dance): a characteristic series of rapid movements without purpose of the face and arms, occurring late in the disease for at least three months from the onset
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Minor criteria:[6][7][8]
- Fever of 100-102°F (38.2-38.9°C)
- Arthralgia: Joint pain without swelling (Cannot be included if polyarthritis is present as a major symptom)
- Raised erythrocyte sedimentation rate or C reactive protein
- Leukocytosis
- ECG showing features of heart block, such as a prolonged PR interval[6] (Cannot be included if carditis is present as a major symptom)
- First degree AV block[7]
- Previous episode of rheumatic fever or inactive heart disease
References
- ↑ 1.0 1.1 Jones TD (1944). "The diagnosis of rheumatic fever". JAMA. 126: 481–4.
- ↑ 2.0 2.1 Ferrieri P; Jones Criteria Working, Group (2002). "Proceedings of the Jones Criteria workshop". Circulation. 106 (19): 2521–3. doi:10.1161/01.CIR.0000037745.65929.FA. PMID 12417554.
- ↑ Steven J Parrillo, DO, FACOEP, FACEP. "eMedicine — Rheumatic Fever". Retrieved 2007-07-14.
- ↑ "Guidelines for the diagnosis of rheumatic fever. Jones Criteria, 1992 update. Special Writing Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association". JAMA. 268 (15): 2069–73. 1992. doi:10.1001/jama.268.15.2069. PMID 1404745.
- ↑ Saxena, Anita (2000). "Diagnosis of rheumatic fever: Current status of Jones criteria and role of echocardiography". Indian Journal of Pediatrics. 67 (4): 283–6. doi:10.1007/BF02758174. PMID 11129913.
- ↑ 6.0 6.1 Aly, Ashraf (2008). "Rheumatic Fever". Core Concepts of Pediatrics. University of Texas. Retrieved 2011-08-06.
- ↑ 7.0 7.1 Ed Boon, Davidson's General Practice of Medicine, 20th edition. P. 617.
- ↑ Balli S, Oflaz MB, Kibar AE, Ece I (February 2013). "Rhythm and conduction analysis of patients with acute rheumatic fever". Pediatr Cardiol. 34 (2): 383–9. doi:10.1007/s00246-012-0467-5. PMID 22868672.