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1987 Criteria for the
Classification of Acute Arthritis of Rheumatoid Arthritis
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Criterion
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Definition
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1. Morning
stiffness
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Morning
stiffness in and around the joints, lasting at least 1 hour before maximal
improvement
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2. Arthritis
of 3 or more joint areas
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At least
3 joint areas simultaneously have had soft tissue swelling or fluid (not
bony overgrowth alone) observed by a physician. The 14 possible areas are
right or left PIP, MCP, wrist, elbow, knee, ankle, and MTP joints
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3. Arthritis
of hand joints
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At least
1 area swollen (as defined above) in a wrist, MCP, or PIP joint
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4. Symmetric
arthritis
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Simultaneous
involvement of the same joint areas (as defined in 2) on both sides fo the
body (bilateral involvement of PIPs, MCPs, or MTPs is acceptable without
absolute symmetry)
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5. Rheumatoid
nodules
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Subcutaneous
nodules, over bony prominences, or extensor surfaces, or in juxtaarticular
regions, observed by a physician
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6. Serum
rheumatoid factor
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Demonstration
of abnormal amounts of serum rheumatoid factor by any method for which the
result has been positive in <5% of normal control subjects
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7. Radiographic
changes
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Radiographic
changes typical of rheumatoid arthritis on posteroanterior hand and wrist
radiographs, which must include erosions or unequivocal bony decalcification
localized in or most marked adjacent to the involved joints (osteoarthritis
changes alone do not qualify)
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* For
classification purposes, a patient shall be said to have rheumatoid arthritis
if he/she has satisfied at least 4 or these 7 criteria. Criteria 1 through 4
must have been present for at least 6 weeks. Patients with 2 clinical diagnoses
are not excluded. Designation as classic, definite, or probable rheumatoid arthritis
is not to be made.
Arnett FC, Edworthy
SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism
Association 1987 revised criteria for the classification of rheumatoid arthritis.
Arthritis Rheum 1988;31:315---24.
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