The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis

Abstract

Abstract 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.

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Affiliated Institutions

• Harvard University US
• University of Louisville US
• University of Pittsburgh US
• Tift County School District US
• Stanford University US
• Arthritis and Rheumatism Associates US
• The University of Texas Health Science Center at Houston US
• University of Saskatchewan CA
• Tufts Medical Center US
• National Institute of Arthritis and Musculoskeletal and Skin Diseases US
• Virginia Mason Medical Center US
• New York University US
• Brown University US
• Mayo Clinic in Arizona US

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