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    ACR/EULAR 2010 Rheumatoid Arthritis Classification Criteria

    Diagnoses rheumatoid arthritis (RA) in patients with undifferentiated inflammatory synovitis.
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    INSTRUCTIONS

    Use in patients who have at least one swollen joint and no better explanation for synovitis.

    When to Use

    Do you use the ACR/EULAR Criteria for Rheumatoid Arthritis and want to contribute your expertise? Join our contributor team!

    0
    1 large joint
    1
    2-10 large joints
    2
    1-3 small joints (with or without involvement of large joints)
    3
    4-10 small joints (with or without involvement of large joints)
    5
    >10 joints (at least 1 small joint)
    0
    Negative rheumatoid factor and negative anti-citrullinated protein antibody
    2
    Low-positive rheumatoid factor or low-positive anti-citrullinated protein antibody
    3
    High-positive rheumatoid factor or high-positive anti-citrullinated protein antibody
    0
    Normal CRP and normal ESR
    1
    Abnormal CRP or abnormal ESR
    0
    <6 weeks
    1
    ≥6 weeks

    Diagnostic Result:

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    Next Steps
    Evidence
    Creator Insights

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    Do you use the ACR/EULAR Criteria for Rheumatoid Arthritis and want to contribute your expertise? Join our contributor team!

    Formula

    Addition of the selected points:

    Variable

    Points

    Joint involvement*

    1 large joint

    0

    2-10 large joints

    1

    1-3 small joints (with or without involvement of large joints)

    2

    4-10 small joints (with or without involvement of large joints)

    3

    >10 joints (at least 1 small joint)

    5

    Serology (need at least one serology test result to use these criteria)**

    Negative rheumatoid factor and negative anti-citrullinated protein antibody

    0

    Low-positive rheumatoid factor or low-positive anti-citrullinated protein antibody

    2

    High-positive rheumatoid factor or high-positive anti-citrullinated protein antibody

    3

    Acute-phase reactants (need at least one acute-phase reactant test result to use these criteria)***

    Normal CRP and normal ESR

    0

    Abnormal CRP or abnormal ESR

    1

    Duration of symptoms****

    <6 weeks

    0

    ≥6 weeks

    1

    *Any swollen or tender joint on examination, which may be confirmed by synovitis on imaging. Excludes DIP joints, first MCP joints, and first MTP joints. Categories of joint distribution are classified according to the location and number of involved joints, with placement into the highest category possible based on the pattern of joint involvement. “Large joints” = shoulders, elbows, hips, knees, and ankles. “Small joints” = MCP joints, PIP joints, 2nd-5th MTP joints, thumb IP joints, and wrists.

    **Negative = IU values ≤ULN for the lab and assay; low-positive = IU values >ULN but <3x ULN; high-positive = IU values ≥3x. If RF reported only as positive or negative, positive result should be scored as low-positive for RF.

    ***According to lab.

    ****Duration = patient self-report of the duration of synovitis signs/symptoms (e.g. pain, swelling, tenderness) in joints clinically involved at the time of assessment, regardless of treatment status.

    Facts & Figures

    Interpretation:

    Score

    Diagnosis

    ≥6

    Definite RA

    <6

    Not classifiable as having RA by ACR/EULAR Criteria


    Dr. Daniel Aletaha

    About the Creator

    Daniel Aletaha, MD, is an associate professor and consultant physician in the division of rheumatology at the Medical University in Vienna, Austria. His research focuses on clinical and translational science in inflammatory rheumatic disease.

    To view Dr. Daniel Aletaha's publications, visit PubMed