ARA revised criteria for the classification of rheumatoid arthritis

ARA revised criteria for the classification of rheumatoid arthritis

RA is a chronic systemic inflammatory disease of unknown cause that primarily affects the peripheral joints in a symmetric pattern [Howard R Smith]

Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required.

The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.

1) Morning stiffness in and around joints lasting at least 1 hour before maximal improvement;

2) Soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician;

3) Swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints;

4) Symmetric swelling (arthritis);

5) Rheumatoid nodules;

6) The presence of rheumatoid factor; and

7) Radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints.

Notes: Criteria 1 through 4 must have been present for at least 6 weeks.

Reference:

1. Arnett FC, Edworthy SM, Bloch DA et al, "The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.", Arthritis Rheum. 1988 Mar;31(3):315-24, Medline

2. Howard R Smith, "Rheumatoid Arthritis", http://emedicine.medscape.com/article/331715-overview, accessed on 5 April 2010, 9.40 pm