The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis

Frank C. Arnett, Steven M. Edworthy, Daniel A. Bloch, Dennis J. Mcshane, James F. Fries, Norman S. Cooper, Louis A. Healey, Stephen R. Kaplan, Matthew H. Liang, Harvinder S. Luthra, Thomas A. Medsger, Donald M. Mitchell, David H. Neustadt, Robert S. Pinals, Jane G. Schaller, John T. Sharp, Ronald L. Wilder, Gene G. Hunder

Research output: Contribution to journalArticlepeer-review

17549 Scopus citations

Abstract

The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non‐RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a “classification tree” schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91–94% sensitivity and 89% specificity for RA when compared with non‐RA rheumatic disease control subjects.

Original languageEnglish (US)
Pages (from-to)315-324
Number of pages10
JournalArthritis & Rheumatism
Volume31
Issue number3
DOIs
StatePublished - Mar 1988

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

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