2010 American College of Rheumatology European League Against Rheumatism criteria for the classification of Rheumatoid Arthritis
With the knowledge that early effective treatment in RA improves long-term outcomes, the 2010 ACR/EULAR classification criteria for RA were designed to identify individuals with RA at an earlier stage of disease compared with the 1987 ACR RA classification criteria. The criteria demonstrate 82% sensitivity and 61% specificity for RA when compared with control subjects with non-RA rheumatic disease. While these criteria can be a guide, the purpose of classification is to define a homogenous population for study purposes. Ultimately, the diagnosis of RA is established by the rheumatologist.
The 2010 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Rheumatoid Arthritis
From Aletaha D, Neogi T, Silman AJ et al: 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69:1580–1588.
| 1. Joint involvement (swollen or tender joint on examination) | (0–5 points max) |
| • One medium to large joint (shoulders, elbows, hips, knees, ankles) | 0 |
| • 2–10 medium to large joints | 1 |
| • 1–3 small joints (MCP, PIP, 2–5 MTP, or wrist with or without large joint involvement) | 2 |
| • 4–10 small joints (with or without large joint involvement) | 3 |
| • >10 joints (at least one small joint involved) | 5 |
| 2. Serology | (0–3 points max) |
| • Negative RF and negative ACPA | 0 |
| • Low positive RF or low positive ACPA (<=3 times the normal upper limit) | 2 |
| • High positive RF or high positive ACPA (>3 times the normal upper limit) | 3 |
| 3. Acute-phase reactants | (0–1 point max) |
| • Normal CRP and normal ESR | 0 |
| • Abnormal CRP or abnormal ESR | 1 |
| 4. Duration of symptoms | (0–1 point max) |
| • <6 weeks | 0 |
| • ≥6 weeks | 1 |
To apply these criteria, the patient must have at least one joint swollen with inflammatory arthritis on clinical examination that is not explained by another disease. Magnetic resonance imaging/ultrasound may be used to confirm clinical findings.ACPA , anticitrullinated protein antibody; CRP , C-reactive protein; ESR , erythrocyte sedimentation rate; MCP , metacarpophalangeal joint; MTP , metatarsophalangeal joint; PIP , proximal interphalangeal joint; RF , rheumatoid factor.
