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Rheumatoid Arthritis Criteria (1987 revision, American Rheumatism Association)

Morning stiffness Morning stiffness in and around the joints, lasting at least 1 hour before maximal improvement. Symptoms present for a minimum of 6 weeks. (1 point) Arthritis of 3 or more joint areas At least 3 joint areas simultaneously have had soft tissue swelling or fluid (not bony overgrowth alone) observed by aphysician; the 14 possible joint areas are right or left proximal interphalangeal (PIP) joints, metacarpophalangeal (MCP)joints, wrist, elbow, knee, ankle, and metatarsophalangeal (MPT) joints. Findings present for a minimum of 6 weeks. (1 point) Arthritis of hand joints At least one area swollen (as defined above) in a wrist, MCP or PIP joint. Findings present for a minimum of 6 weeks. (1 point) Symmetric arthritis Simultaneous involvement of the same joint areas (see 2 above) on both sides of the body (bilateral involvement of PIPs, MCPs, or MTPs is acceptable without absolute symmetry). Findings present for a minimum of 6 weeks. (1 point) Rheumatoid nodules Subcutaneous nodules, over bony prominences, or extensor surfaces, or in juxta-articular regions, observed by a physician. (1 point) Serum rheumatoid factor Demonstration of abnormal amounts of serum rheumatoid factor by any method for which the result has been positive in <5% of normal control subjects. (1 point) Radiographic changes Radiographic changes typical of RA on posteroanterior hand and wrist radiographs, which must include erosions or unequivocal bony decalcification localized to or most marked adjacent to the involved joints (osteoarthritis changes alone do not qualify). (1 point)

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Total Criteria Point Count:

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Notes

Rheumatoid Arthritis is diagnosed by an RA score of 4-7 points.

References

Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988 Mar;31(3):315-24. PubMed ID: 3358796

Associated Medical Subject Headings [MeSH]

Arthritis, Humans, Medical, Rheumatoid, Rheumatology, Societies, Terminology as Topic

Associated HCC ICD10-CM codes

M06.9

Rheumatoid arthritis unspecified

M05.40

RA with myopathy

M45.9

RA, spine

M05.50

Polyneuropathy in RA

Associated ICD9-CM codes

729.0

Rheumatism nos

714.0

Rheumatoid arthritis

V82.2

Screen-rheumat dis nec

V82.1

Screen-rheumatoid arthr

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