Rheumatoid Arthritis Criteria Mnemonics

The 2 commonly used criteria for diagnosis of rheumatoid arthritis will be discussed here.

1987 ACR Criteria

Mnemonic: DMARDs if MADRAS

  1. Morning stiffness (>1 hour)
  2. Arthritis in >/= 3 joint areas
  3. Duration >6 weeks (of morning stiffness and other 3 features involving arthritis)
  4. Rheumatoid nodules
  5. Rheumatoid factor
  6. Radiographic changes (erosions)
  7. Arthritis of hand joints (>/= 1 swollen joint)
  8. Symmetrical arthritis

For diagnosis of RA: 4 out of 7 criteria must be present (except duration) and criteria listed above in number 1, 2, 7 and 8 must be present for >6 weeks to be established as criteria for RA.

Established RA: Sensitivity 79-80% and Specificity 90-93%

Early RA: Sensitivity 77-80% and Specificity 33-77%


2010 ACR/EULAR Criteria

Mnemonic: Three “A” and Two “6”

a. Arthritis (Joint involvement)

Large joints have smaller points and odd numbers of joint involvement get even numbered points.

  1. 1 Large joint: 0
  2. 2-10 Large joints: 1
  3. 1-3 Small joints: 2
  4. 4-10 Small joints: 3
  5. >10 Joints (atleast 1 small joint): 5

b. Autoantibodies (RF and ACPA)

  1. Both negative: 0
  2. Any one is low positive: 2
  3. Any one is high positive: 3

c. Acute phase reactants (CRP and ESR)

  1. Both normal: 0
  2. Any one is abnormal: 1

d. 6 weeks duation

  1. <6 weeks duration: 0
  2. >6 weeks duration: 1

e. >6/10 points = Definite RA

2010 Criteria increased the sensitivity for finding patients with early-stage disease who were destined eventually to develop full-blown RA over the next 6 years to 86% sensitivity, compared with 78% sensitivity for the 1987 criteria.


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