III. Criteria

  1. Points clc: Age (calculated points = AgeYrs * 0.02)
  2. Points 1.0: Female Gender
  3. Points 0.5: Small joints of hands or feet affected
  4. Points 0.5: Symmetric joints involved
  5. Choose one
    1. Points 1.0: Upper extremities affected
    2. Points 1.5: Upper and lower extremities affected
  6. Choose one
    1. Points 1.0: Morning stiffness rated at 26-90 mm on a 100 mm visual analog scale
    2. Points 2.0: Morning stiffness rated at >90 mm on a 100 mm visual analog scale
  7. Choose one
    1. Points 0.5: Number of tender joints 4-10
    2. Points 1.0: Number of tender joints 11 or more
  8. Choose one
    1. Points 0.5: Number of swollen joints 4-10
    2. Points 1.0: Number of swollen joints 11 or more
  9. Choose one
    1. Points 0.5: C-Reactive Protein 5 to 50 mg/L
    2. Points 1.5: C-Reactive Protein >51 mg/L
  10. Points 1.0: Rheumatoid Factor positive
  11. Points 2.0: Anti-Citrullinated Protein Antibody positive

IV. Interpretation: Based on total cummulative score tallied from above criteria

  1. Lower Risk
    1. Score 0.0 - 3.5: Percentage with RA at one year 0% (LR 0)
    2. Score 3.5 - 6.5: Percentage with RA at one year 16% (LR 0.4)
  2. Higher Risk (rheumatology referral indicated)
    1. Score 6.5 - 8.5: Percentage with RA at one year 57% (LR 3.0)
    2. Score over 8.5: Percentage with RA at one year 85% (LR 12.7)

V. Resources

  1. Leiden Clinical Prediction Rule for Undifferentiated Arthritis (MDCalc)
    1. https://www.mdcalc.com/calc/10023/leiden-clinical-prediction-rule-undifferentiated-arthritis

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