Abstract

The 1987 ACR criteria were developed to separate rheumatoid arthritis (RA) patients with non-RA rheumatic disease control subjects. They are not adapted to diagnosis of early RA. The current challenge is to identify, among patients with early arthritis, which patient will develop persistent or erosive disease, to propose them a disease modifying antirheumatic drug. Therefore, the gold standard for the 2010 ACR/EULAR classification criteria for RA was treatment with methotrexate during the first year after enrolment. Classification as "definite RA" is based on the confirmed presence of synovitis in at least 1 joint, absence of an alternative diagnosis that better explains the synovitis, and achievement of a total score of 6 or greater (of a possible 10) from the individual scores in 4 domains: number and site of involved joints, serologic abnormality, elevated acute-phase response, and symptom duration.

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