Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
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    • Suggested protocolsAlgorithm

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    Leiden Clinical Prediction Rule for Undifferentiated Arthritis

    Diagnoses rheumatoid arthritis in patients with recent-onset undifferentiated arthritis.
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    years
    Male
    0
    Female
    +1
    Small joints in hands/feet
    +0.5
    Upper extremities only
    +1
    Upper and lower extremities
    +1.5
    Other
    0
    No
    0
    Yes
    +0.5
    <30 min
    0
    30-59 min
    +0.5
    ≥60 min
    +1
    <4
    0
    4-10
    +0.5
    ≥11
    +1
    <4
    0
    4-10
    +0.5
    ≥11
    +1
    <5
    0
    5-50
    +0.5
    ≥51
    +1.5
    Negative
    0
    Positive
    +1
    Negative
    0
    Positive
    +2

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

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    Formula

    Age x 0.02 + sum of all other selected points:

    Variable

    Points

    Age, years

    Multiply by 0.02

    Sex





    Male

    0

    Female

    1

    Distribution of involved joints

    Small joints in hands/feet

    0.5

    Upper extremities only

    1

    Upper and lower extremities

    1.5

    Other

    0

    Symmetric distribution

    No

    0

    Yes

    0.5

    Duration of morning stiffness

    <30 min

    0

    30-59 min

    0.5

    ≥60 min

    1

    Number of tender joints (out of 68)

    <4

    0

    4-10

    0.5

    ≥11

    1

    Number of swollen joints (out of 66)

    <4

    0

    4-10

    0.5

    ≥11

    1

    C-reactive protein level, mg/L

    <5

    0

    5-50

    0.5

    ≥51

    1.5

    Rheumatoid factor

    Negative

    0

    Positive

    1

    Anti-CCP antibodies

    Negative

    0

    Positive

    2

    Facts & Figures

    Interpretation:

    Score

    Risk group*

    ≤6.0

    Low

    >6.0 and <8.0

    Indeterminate

    ≥8.0

    High

    *In the validation study including 3 separate cohorts, combined negative predictive value for developing rheumatoid arthritis was 83% for scores ≤6.0, and combined positive predictive value for scores ≥8.0 was 97%.

    Literature

    Dr. Annette H. van der Helm-van Mil

    About the Creator

    Annette H. van der Helm-van Mil, MD, PhD, is a professor in the rheumatology department at Erasmus Medical Center in Rotterdam, Netherlands. She is also a practicing rheumatologist at Leiden University Medical Center in Leiden, Netherlands. Dr. van der Helm-van Mil’s primary research is focused on early arthritis, arthralgia, and imaging.

    To view Dr. Annette H. van der Helm-van Mil's publications, visit PubMed

    About the Creator
    Dr. Annette H. van der Helm-van Mil