The previously recommended diagnostic criteria used in Acute Rheumatic Fever has been modified in 2014 by the WHO and American Heart Association. Segregartion of the risk group into High risk and low risk group is an important feature.Low risk population are those who have incidence of RHD (Rhematic Heart disease) less than or equal to 1/1000 population/year and incidence of ARF (Acute Rheumatic Fever ) less than or equal to two /100000 population.
The previously accepted Jones Criteria still holds true for the low risk population.
HOWEVER, in the high risk population just the presence of MONOARTHRITIS or POLYARTHALGIA is sufficient to diagnose the ARF as MAJOR CRITERIA unlike in previous system where polyarthritis was must.
Similarly in Minor Criteria the presence of MONOARTHALGIA is sufficient to daignose the condition. The value of ESR measured on the 1st hour with a value >= 30mm/hr is sufficeint in low reisk populationwhile that of >= 60mm/hr is needed in low risk population to consider acute rheumatic fever.
Presence of Clinically evident Sydenham Chorea is enough to diagnose the ARF.
Similarly, Arthritis with Carditis is enough to diagnose the condition.
Presence of Subcutaneous nodule or Erythema Marginatum with one of the major criteria diagnoses the condition.
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| Revised Jones Criteria 2014 Screenshot taken from http://circ.ahajournals.org/content/early/2015/04/23/CIR.0000000000000205 |
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