RHEUMATOID ARTHRITIS-DIAGNOSIS

SUMMARY

RA can be diagnosed when all of the following are present (2010 ACR/EULAR criteria):
1. Inflammatory arthritis (from 1-10 large/small joints)
2. Duration > 6 weeks

3. RF and/or anti-CCP Ab
4. Increased ESR or CRP
5. Other causes must be excluded (especially if symptoms have been present for < 6 weeks), such as SLE, Sjogren's, overlap syndromes, sarcoidosis, and viral reactive arthritis (hepatitis B and C, parvovirus B19).

MISC
6. Seronegative RA (less severe disease) is diagnosed when patients meet other criteria but lack both RF and anti-CCP.

7. American College of Rheumatology criteria for RA can also be used for diagnosis (4/7 positive): morning joint stiffness > 6 wks, arthritis of > 3 joints for > 6 wks, arthritis of hand joints > 6 wks, symmetric arthritis > 6 wks, rheumatoid nodules, RF positive, radiographic changes.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].