2010 American College of Rheumatology European League Against Rheumatism criteria for the classification of Rheumatoid Arthritis

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 joints1
• 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 ACPA0
• 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 ESR0
• Abnormal CRP or abnormal ESR1
4. Duration of symptoms(0–1 point max)
• <6 weeks0
• ≥6 weeks1

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.

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