Patients suffering from rheumatoid arthritis can be very painful in nature. This disease is an auto immune and systemic inflammatory disorder, which affects the synovial joints. Symptoms of rheumatoid arthritis are mainly, severe pain, swelling and stiffness in the joints. Rheumatoid arthritis’s pathogenesis is multiple and certainly inconclusive. Symptoms in R A are many and common to many other diseases also. Physicians take extra care to treat R A, any wrong medications can lead to harmful consequences. So to be absolutely sure of this specific disease physicians and researchers made a bench mark, simply for the classification purposes.
This classification of rheumatoid arthritis diagnosis criteria must fulfill at least four out of seven criteria. They are as follows: 1. Morning stiffness. 2. Arthritis in more than three joint areas. 3. Arthritis of hand joints. 4. Symmetric arthritis. 5. Rheumatoid nodules. 6. Serum rheumatoid factor. 7. Radiographic changes. These are all 1987 criteria by American college of rheumatology formerly known as “The American rheumatism association or ACR”. Criteria for the classification of R A have been severely criticized because of the lack of sensitivity in the early days of disease. A new rheumatoid arthritis diagnosis criterion was undertaken by ACR and the European league against rheumatism, EULAR in the year 2010. A three phase approach to classify R A in a whole new ways. This current pattern of R A diagnosis criteria is mainly based upon detecting the disease at earliest stages rather than its late stage inspection. The reviews of the joint committee have stated that a point value from zero to ten has to be established. The patient with the total of six points or higher has to be classified as rheumatoid arthritis. There are mainly four areas to be covered, they are; 1. Joint involvement. 2. Serology. 3. Acute phase reactants. 4. Duration of symptoms.
JOINT INVOLVEMENT: Meatacarpophalangeal joints, proximal interphalangeal joints, interphalangeal joints, wrists, were tagged as small joints, Hip joints, shoulders, elbows knees and ankles as large joints.
POINTS SYSTEM OF THE JOINTS ON THE SCORE OF ZERO TO TEN
One large joint involvement in the body gives zero point.
Two to up to ten large joints provides one point.
One or up to three joints involvement score two points.
Three points for four or up to ten small joints.
For more than ten joints provides five points.
SEROLOGY: (A minimum of one test result is necessary for the classification)
Rheumatoid factor R F negative and negative anti citrullinated protein antibody A C P A gives zero point.
Both low positive R F and low positive A C P A provides two points.
High positive R F or high positive A C P A scores three points.
ACUTE PHASE RECTANTS: (A minimum of one test result is necessary for the classification) “E s R- Erythrocyte sedimentation rate, C- reactive protein”.
Both C R P and E S R with normal is zero point.
Both with abnormal C R P and E S R are one point.
DURATION OF SYMPTOMS
If less than six weeks is zero point.
If more than or precisely six weeks one points.
These new rheumatoid arthritis diagnosis criteria are particularly helpful to detect the disease in its early stage. This allows patients to suffer less for the incurable disease.