April 5, 2010

ARA revised criteria for the classification of rheumatoid arthritis

ARA revised criteria for the classification of rheumatoid arthritis

RA is a chronic systemic inflammatory disease of unknown cause that primarily affects the peripheral joints in a symmetric pattern [Howard R Smith]

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.

The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.

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.

Notes: Criteria 1 through 4 must have been present for at least 6 weeks.


1. 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, Medline

2. Howard R Smith, "Rheumatoid Arthritis", http://emedicine.medscape.com/article/331715-overview, accessed on 5 April 2010, 9.40 pm


  1. salam.just nk share.rheumatoid arthritis (RA) yg ada 7 ni kalau x silap dikeluarkan thn 87.
    masa discussion dgn Prof. Shahrir (PPUKM),prof kata ada the latest criteria for RA.according to him, skrg guna 4 domain.
    1.joint pain
    3.duration of synovitis
    4.acute phase reactant (ESR,CRP)

  2. to tautan hati..

    owh. thanks, can u explain more about it and where can i find the new classification. i want to put it inside my blog..


  3. Talk to your doctor. Meanwhile, eat a good diet with seafood (or cod liver oil) and lots of fresh vegetables and fruits, get enough vitamins & minerals. Cut way back on red meats and try to stay away from fats, oils (we use olive oil now), and sugars and pastries.


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