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    Jones Criteria for Acute Rheumatic Fever Diagnosis

    Diagnoses acute rheumatic fever based on major and minor criteria.
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    When to Use
    Pearls/Pitfalls
    • Use in initial attacks of acute rheumatic fever (ARF).
    • Do not use to measure rheumatic activity, establish the diagnosis of inactive or chronic rheumatic heart disease, or predict course or severity of disease.
    • An initial attack of ARF should not be diagnosed based on minor criteria.
    • Other illnesses may mimic ARF. Lab evidence of an antecedent group A streptococcal (GAS) infection (i.e., streptococcal antibody titers or positive throat culture or rapid strep test).
    • Intended only for the diagnosis of initial attacks of ARF.
    • A 2015 revision made modifications to the criteria, most notably providing two separate diagnostic pathways for those at low risk and those at moderate/high risk, and adding subclinical carditis as a major criterion. However, the 1992 (original) version remains popular in clinical use.
    Required Criteria

    At least 1 required for positive diagnosis.

    Major Criteria

    2+ required for positive diagnosis (or 1 with 2+ minor).

    Minor Criteria

    2+ required for positive diagnosis with 1+ major.

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Cases of isolated chorea, indolent carditis, or recurrent attacks of rheumatic fever are more suggestive of rheumatic fever regardless of the presence of other Jones Criteria. In these scenarios, ARF is the presumptive diagnosis until proven otherwise.

    About the Creator
    Dr. T. Duckett Jones
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