Rheumatology Book

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Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis

Aka: Rheumatoid Arthritis Prediction Rule for Undifferentiated Arthritis
  1. Indications
    1. Rheumatoid Arthritis Diagnosis
  2. Criteria
    1. Points clc: Age (calculated points = AgeYrs * 0.02)
    2. Points 1.0: Female Gender
    3. Points 0.5: Small joints of hands or feet affected
    4. Points 0.5: Symmetric joints involved
    5. Points 1.0: Upper extremities affected
    6. Points 1.5: Upper and lowe extremities affected
    7. Points 1.0: Morning stiffness rated at 26-90 mm on a 100 mm visual analog scale
    8. Points 2.0: Morning stiffness rated at >90 mm on a 100 mm visual analog scale
    9. Points 0.5: Number of tender joints 4-10
    10. Points 1.0: Number of tender joints 11 or more
    11. Points 0.5: Number of swollen joints 4-10
    12. Points 1.0: Number of swollen joints 11 or more
    13. Points 0.5: C-Reactive Protein 5 to 50 mg/L
    14. Points 1.5: C-Reactive Protein >51 mg/L
    15. Points 1.0: Rheumatoid Factor positive
    16. Points 2.0: Anti-Citrullinated Protein Antibody positive
  3. Interpretation: Based on total cummulative score tallied from above criteria
    1. Score 0.0 - 3.5: Percentage with RA at one year 0% (LR 0)
    2. Score 3.5 - 6.5: Percentage with RA at one year 16% (LR 0.4)
    3. Score 6.5 - 8.5: Percentage with RA at one year 57% (LR 3.0)
    4. Score over 8.5: Percentage with RA at one year 85% (LR 12.7)
  4. References
    1. van der Helm-van Mil (2007) Arthritis Rheum 56(2): 433-40 [PubMed]
    2. Mochan (2008) Am Fam Physician 77(10): 1451-3 [PubMed]

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