Rheumatology Question 16 Instructor

What are the diagnostic criteria for rheumatoid arthritis?

  • Morning stiffness lasting >1 hour
  • Arthritis of 3 or more joints
  • Hand joint arthritis
  • Symmetrical joint involvement
  • Rheumatoid factor positivity
  • Periarticular erosions
  • Rheumatoid nodules

A patient is classified as having rheumatoid arthritis if 4 of these 7 criteria are present. The first 4 must be present for >6 weeks.

Assays for anti-CCP antibodies can also be helpful in the diagnosis of RA, though they have not been included to date in the classification criteria. Anti-CCP antibodies are more specific (~90%) for rheumatoid arthritis than RF and they have a similar sensitivity. Their presence also predicts erosive disease.

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