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2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis

Classifies definite RA in patients with at least one clinically involved joint.

2010 ACR/EULAR Classification Criteria for Rheumatoid Arthritis
Joint involvement
Small joints: MCP, PIP, 2nd-5th MTP, thumb IP, wrists. Large: shoulder, elbow, hip, knee, ankle.
Serology (RF and anti-CCP/ACPA)
Low-positive: above upper limit of normal but <=3x ULN. High-positive: >3x ULN.
Acute-phase reactants (CRP and ESR)
Duration of symptoms
Result0 points / 10

Below the threshold of 6 for definite RA. Patients not meeting criteria may be reassessed longitudinally as findings evolve.

Total score
0 / 10
Meets criteria for definite RA
No (<6)

When to use

  • Classifying newly presenting patients with at least one joint showing clinical synovitis not explained by another disease.
  • Standardising RA enrolment for research and early-treatment decisions.

Formula

Add points from four domains: joint involvement (0-5), serology (0-3), acute-phase reactants (0-1), symptom duration (0-1). Range 0-10; score >=6 classifies definite RA.

Pearls and pitfalls

  • Applied only to patients with definite clinical synovitis in at least one joint.
  • Distal interphalangeal joints, first CMC and first MTP are excluded from the joint count.

References

  1. Aletaha D, et al. Arthritis Rheum. 2010;62(9):2569-81.