Abstract
In the era of new diagnostic tools as anti-citrullinated proteins antibodies and new concepts as window of opportunity, it seemed a few years ago that it was time to revise 1987 rheumatoid arthritis (RA) classification criteria. It was a process of international consensus that took several years and was conclude in 2010. The new 2010 ACR/EULAR criteria were at first conceived as RA classification criteria in order to homogenize the populations of patients included in clinical trials. However, they are currently frequently used as RA diagnostic criteria in order to optimize early diagnosis and treatment. In comparison to the old 1987 criteria, the sensitivity is higher but the specificity is lower. Consequently, the main limitation of the new criteria is the risk of over-diagnosis and over-treatment. Trying to improve the sensitivity of the criteria, for example by using imaging exams to detect synovitis, might increase this risk.
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