The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.
The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a "classification tree" schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.
Arnett
F C
FC
American Rheumatism Association, Atlanta, GA 30329.
Edworthy
S M
SM
Bloch
D A
DA
McShane
D J
DJ
Fries
J F
JF
Cooper
N S
NS
Healey
L A
LA
Kaplan
S R
SR
Liang
M H
MH
Luthra
H S
HS
D001172:Arthritis, Rheumatoid / Q000145:classification* / Q000175:diagnosis; D006801:Humans; D012219:Rheumatology / Q000639:trends; D012955:Societies, Medical; D009626:Terminology as Topic; D014481:United States