The American Rheumatism Association 1987 revision criteria for Rheumatoid Arthritis include 7 items. A patient can be diagnosed with Rheumatoid Arthritis if:

• Meets at least 4 of the 7 criteria
• For items 1, 2, 3, or 4; the symptoms must have been present for >=6 weeks
• In cases where 3 criteria are met, RA cannot be excluded
• In cases where 2 or less criteria are met, RA is unlikely

1. Morning Stiffness (>=6 weeks)

Morning stiffness in and around the joints; lasting at least 1 hour before maximal improvement

2. Arthritis of >= 3 joint areas (>=6 weeks)

At least 3 joint areas [14 possible areas include Right or Left PIP, MCP, wrist, elbow, knee, ankle and MTP joints] must have simultaneously have had soft tissue swelling or joint fluid (not bony overgrowth alone) that was observed by a physician

3. Arthritis of hand joints (>=6 weeks)

At least 1 area swollen (as defined in criteria #2) in a Right and/or Left wrist, MCP, or PIP joint

4. Symmetric arthritis (>=6 weeks)

Simultaneous involvement of the same joint areas (as defined in criteria #2) on both sides of the body (bilateral involvement of PIPs, MCPs or MTP does meet this criteria without absolute symmetry)

5. Rheumatoid nodules

Presence of subcutaneous nodules over bony prominences or extensor surfaces or juxta-articular regions (observed by a physician)

6. Rheumatoid factor (Serum)

Presence of positive rheumatoid factor (by method where less than 5% are normal control subjects test positive)

7. Radiographic changes

Presence of radiographic changes that are typical of RA on posteroanterior hand and wrist radiographs, which must include erosions or unequivocal bony decalcification localized to or most marked adjacent to the involved joints (osteoarthritis changes alone do not qualify)

Reference:

• Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-24.