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The Role of the Laboratory in the Diagnosis of Rheumatoid Arthritis



2010 Classification Criteria for Rheumatoid Arthritis

Slide 6

August 2011

Just recently, new criteria for rheumatoid arthritis were published. One goal of these criteria was to improve the classification of patients with early, less severe disease, while still allowing for their application to patients with more established or advanced disease.

The first question that was asked was “Which patients should be evaluated using these criteria?” It was determined that these criteria should only be used in patients who have at least 1 joint with definitive clinical synovitis and for whom the synovitis is not caused by another disease process or trauma.

Once the appropriate patient is identified, the classification criteria uses a scoring system based on clinical and laboratory evaluation.

The clinical criteria focus on joint involvement, with the involvement of numerous small joints generating a score of up to 5 points, in comparison to involvement of between 2 and 10 large joints, which is only given a score of 1 point.

Duration of symptoms is also important, with symptoms lasting at least 6 weeks adding another point to the total score. The laboratory also plays a role in this classification system through the evaluation of autoantibody serology and acute phase reactants.

A low-positive result for either rheumatoid factor or anti-CCP antibodies is given a score of 2 points while a high-positive result for either antibody is given a score of 3 points.

Similarly, an elevated C-reactive protein or erythrocyte sedimentation rate adds another 1 point.

All the points for a given patient are then added together, and a score of 6 or higher leads to the classification of that patient as having rheumatoid arthritis.

2010 Classification Criteria for RA

 


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