_id

683a1631c782e11e38d1b264

id

10092

title

ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria

full_title

ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria

short_title

ACR/EULAR 2010 RA Criteria

med_description

Diagnoses rheumatoid arthritis (RA) in patients with undifferentiated inflammatory synovitis.

short_description

RA diagnosis.

slug

acr-eular-2010-rheumatoid-arthritis-classification-criteria

description

The ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria diagnoses rheumatoid arthritis (RA) in patients with undifferentiated inflammatory synovitis.

keywords

synovitis, RA, undifferentiated arthritis

complaint

[ "Chronic Pain", "Extremity Pain", "Joint Pain", "Pain" ]

formula

Addition of the selected points: *Any swollen or tender joint on examination, which may be confirmed by synovitis on imaging. ExcludesDIPjoints, firstCMCjoints, and firstMTPjoints. Categories of joint distribution are classified according to the location and number of involved joints, with placement into the highest category possible based on the pattern of joint involvement. “Large joints” = shoulders, elbows, hips, knees, and ankles. “Small joints” = MCP joints,PIPjoints, 2nd-5th MTP joints, thumbIPjoints, and wrists. **Negative = IU values ≤ULNfor the lab and assay; low-positive = IU values >ULN but ≤3x ULN; high-positive = IU values >3x. IfRFreported only as positive or negative, positive result should be scored as low-positive for RF. ***According to lab. ****Duration = patient self-report of the duration of synovitis signs/symptoms (e.g. pain, swelling, tenderness) in joints clinically involved at the time of assessment, regardless of treatment status.

evidence

measurements

[]

information

Interpretation:

refrences

{ "Clinical Practice Guidelines": [ { "href": "", "text": "" } ], "Manufacturer Website": [ { "href": "", "text": "" } ], "Original/Primary Reference": [ { "href": "https://www.rheumatology.org/Portals/0/Files/2010_revised_criteria_classification_ra.pdf", "text": "Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569-81." } ], "Other References": [ { "href": "", "text": "" } ], "Outcomes": [ { "href": "", "text": "" } ], "Validation": [ { "href": "", "text": "" } ], "Validations": [] }

pearls

• These criteria were created to emphasize RA characteristics, particularly those that emerge early in the disease course and are associated with erosive and/or persistent disease.
• Other inflammatory diseases, like gout, lupus, or psoriatic arthritis, may mimic RA, potentially leading to misclassification.
• Keep in mind, many individuals with RA may not satisfy these criteria, particularly very early on in the course of the disease.

usecase

• Use to evaluate suspected cases of rheumatoid arthritis (RA) in patients with inflammatory synovitis.
• Can be utilized in research or clinical trials to establish a uniform diagnostic standard for RA patients.

reasons

Provides a standardized approach to diagnosing RA, allowing for prompt treatment with disease-modifying antirheumatic drugs (DMARDs).

next_advice

• This tool should be used as a guide in diagnosing RA alongside clinical judgment, diagnostics, and specialist consultation, particularly in borderline or atypical cases.
• Score ≥6 with synovitis in ≥1 joint and absence of an alternative diagnosis: 
  
  • Highly indicative of RA.
  • Refer to a rheumatologist for further management and possible initiation of DMARD therapy.
  • Regularly monitor disease activity and response to therapy.
• Score <6: 
  
  • Consider alternative diagnoses; further diagnostic workup (e.g., imaging, additional labs) may be warranted.
  • Closely monitor and reassess if the patient’s symptoms change or evolve.

next_actions

next_management

diseases

[ "Rheumatoid Arthritis" ]

input_schema

[ { "conditionality": "", "default": 0, "label_en": "Joint involvement", "mdcalc_info_concept": null, "name": "joint", "option_fhir_rules": null, "optional": false, "options": [ { "label": "1 large joint", "value": 0 }, { "label": "2-10 large joints", "value": 1 }, { "label": "1-3 small joints (with or without involvement of large joints)", "value": 2 }, { "label": "4-10 small joints (with or without involvement of large joints)", "value": 3 }, { "label": ">10 joints (at least 1 small joint)", "value": 5 } ], "show_points": true, "tips_en": "Any swollen/tender joint on exam, excluding <abbr title = 'Distal interphalangeal'>DIP</abbr> joints and 1st <abbr title='Metacarpophalangeal'>MCP</abbr>/<abbr title='Metatarsophalangeal'>MTP</abbr> joints; select option that assigns the most possible points; see <a href = \"#evidence\">Evidence</a> for details", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "Serology (need at least one serology test result to use these criteria)", "mdcalc_info_concept": null, "name": "serology", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Negative rheumatoid factor and negative anti-citrullinated protein antibody", "value": 0 }, { "label": "Low-positive rheumatoid factor or low-positive anti-citrullinated protein antibody", "value": 2 }, { "label": "High-positive rheumatoid factor or high-positive anti-citrullinated protein antibody", "value": 3 } ], "show_points": true, "tips_en": "Negative = IU values ≤<abbr title='Upper limit of normal'>ULN</abbr> per lab/assay; low-positive = IU values >ULN but <3x ULN; high-positive = IU values ≥3x ULN; if <abbr title ='Rheumatoid factor'>RF</abbr> reported only as positive or negative, positive result should be scored as low-positive; see <a href = \"#evidence\">Evidence</a> for details", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "Acute-phase reactants (need at least one acute-phase reactant test result to use these criteria)", "mdcalc_info_concept": null, "name": "acute", "option_fhir_rules": null, "optional": false, "options": [ { "label": "Normal CRP and normal ESR", "value": 0 }, { "label": "Abnormal CRP or abnormal ESR", "value": 1 } ], "show_points": true, "tips_en": "According to lab", "type": "radio" }, { "conditionality": "", "default": 0, "label_en": "Duration of symptoms", "mdcalc_info_concept": null, "name": "duration", "option_fhir_rules": null, "optional": false, "options": [ { "label": "<6 weeks", "value": 0 }, { "label": "≥6 weeks", "value": 1 } ], "show_points": true, "tips_en": "Duration = patient self-report of the duration of synovitis signs/symptoms (e.g. pain, swelling, tenderness) in joints clinically involved at the time of assessment, regardless of treatment status", "type": "radio" } ]

instructions

Use in patients who have at least one swollen joint and no better explanation for synovitis.

published

2022-04-21T20:28:17.499Z

purpose

[ "Diagnosis" ]

search_terms

[ "synovitis", "RA", "undifferentiated arthritis", "acr eular" ]

seo

{ "keywords_en": "synovitis, RA, undifferentiated arthritis", "meta_description_en": "The ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria diagnoses rheumatoid arthritis (RA) in patients with undifferentiated inflammatory synovitis." }

specialty

[ "Hospitalist Medicine", "Internal Medicine", "Orthopedics", "Rheumatology" ]

departments

[ "Musculoskeletal", "Rheumatologic" ]

tags

[]

version_number

1

versions

[]

related

[ { "calcId": 10514, "short_title_en": "2012 Criteria for PMR", "slug": "2012-eular-acr-classification-criteria-polymyalgia-rheumatica" }, { "calcId": 10023, "short_title_en": "Leiden Rule for Arthritis", "slug": "leiden-clinical-prediction-rule-undifferentiated-arthritis" }, { "calcId": 10039, "short_title_en": "CASPAR Criteria for PsA", "slug": "caspar-criteria-psoriatic-arthritis" } ]

ismed

false

section

[ "whenToUseViewed", "pearlsPitfallsViewed", "whyUseViewed", "nextStepsViewed", "evidenceViewed" ]

cleaned_departments

[ "orthopedics", "rheumatology" ]

cleaned_use

[ "Use to evaluate suspected cases of rheumatoid arthritis (RA) in patients with inflammatory synovitis.", "Can be utilized in research or clinical trials to establish a uniform diagnostic standard for RA patients." ]

pub

false