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Classification Criteria and Scoring System for Rheumatoid Arthritis (ACR/EULAR)

Number of Affected Joints
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Number of Affected Joints
1 Large Joint
2-10 Large Joints
1-3 Small Joints
4-10 Small Joints
More than 10 Joints (at least 1 small joint)
Serology
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Serology
RF or anti-CCP antibodies both negative
RF or anti-CCP antibodies at least one low positive
RF or anti-CCP antibodies at least one high positive (more than 3 times the upper limit of normal)
Duration of Synovitis
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Duration of Synovitis
Less than 6 weeks
More than 6 weeks
Acute Phase Reactants
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Acute Phase Reactants
Normal CRP and ESR
Elevated CRP or ESR
Score:

Interpretation of Results

In 2009, the ACR and the European League Against Rheumatism (EULAR) proposed new classification criteria and a scoring system for RA: at least one joint with swelling or tenderness, and evidence of synovitis (clinical or ultrasound or MRI); exclusion of other diseases causing arthritis, and typical radiographic changes of RA bone destruction can diagnose RA. Additionally, the criteria score the number of affected joints, serological markers, duration of synovitis, and acute phase reactants, with a total score of 6 or more diagnosing RA.

Typical cases are not difficult to diagnose according to the 1987 ACR classification criteria, but atypical and early RA can easily be misdiagnosed or missed.

References

Research Paper Chinese Medical Association Rheumatology Branch. 2010 Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis. Chinese Journal of Rheumatology. 2010. 14; 265-70.
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