Requirements for clinical diagnosis of JRA

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ACR Clinical Classification Criteria for Juvenile Rheumatoid Arthritis

GENERAL CLASS

a. Persistent arthritis of at least six weeks duration in one or more joints

b. Exclusion of other causes of arthritis (see list of exclusions+)

onset subtypes-determined by manifestations during the first six months of

disease although manifestations more closely resembling another subtype may

appear later

Systemic onset JRA*

subtypes:

Polyarthritis

Oligoarthritis

*Typical fever and rash will be considered probable systemic onset JRA if

not associated with arthritis. Before a definite diagnosis can be made,

arthritis, as defined must be present.

Pauciarticular*

subtypes:

Antinuclear antibody (ANA) positive-chronic uveitis

Rheumatoid factor (RF) positive

Seronegative, B27 positive

Not otherwise classified

*Patients with systemic onset JRA are excluded from this onset subtype.

Polyarticular

subtypes:

RF positivity

Not otherwise classified

*Patients with systemic JRA onset are excluded from this subtype.

+EXCLUSIONS

A. Other rheumatic diseases

a. Rheumatic fever

b. Systemic lupus erythematosus

c. Ankylosing spondylitis

d. Polymyositis or dermatomyositis

e. Vasculitic syndromes

f. Scleroderma

g. Psoriatic arthritis

h. Reiter's syndrome

i. Sjogren's syndrome

j. Mixed connective tissue disease

k. Behcet's syndrome

B. Infectious arthritis

C. Inflammatory bowel disease

D. Neoplastic diseases including leukemia

E. Nonrheumatic conditions of bones and joints

F. Hematologic diseases

G. Psychogenic arthralgia

H. Miscellaneous

a. Sarcoidosis

b. Hypertrophic osteoarthropathy

c. Villonodular synovitis

d. Chronic active hepatitis

e. Familial Mediterranean fever

Reference: JRA Criteria Subcommittee of the Diagnostic and Therapeutic

Criteria Committee of the American Rheumatism Association Arthritis Rheum

20(Suppl)195, 1977

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-Brent