Proceedings of the Jones Criteria workshop.

Abstract

On April 8 and 9, 2000, the members of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the American Heart Association met with a group of international experts on rheumatic fever, rheumatic heart disease, and streptococcal infections to review guidelines for the diagnosis of acute rheumatic fever using the Jones criteria, including the 1992 statement on the “Jones Criteria Updated.”1 Formal presentations during the meeting included an historical review of the Jones criteria, beginning with the original publication in 19442 through several revisions of the guidelines, including the latest statement in 1992.1 A review of the worldwide impact of rheumatic fever and rheumatic heart disease was presented, as well as an overview of the recent resurgence of rheumatic fever in certain regions of the United States. Extensive discussion focused on the diagnostic potential of Doppler echocardiography and its possible role in the diagnosis of acute rheumatic carditis. In addition, data on “silent” rheumatic valvular disease were presented, as well as clinical dilemmas in the diagnosis of rheumatic fever, with special reference to epidemiological challenges in both developing and developed countries. The purpose of the workshop was to review the adequacy of the existing guidelines1 for the diagnosis of first attacks of rheumatic fever and to assess whether contemporary diagnostic techniques, specifically two-dimensional and Doppler echocardiography, could be added to the criteria for the diagnosis of rheumatic carditis/valvulitis. Other issues that were addressed included the diagnosis of recurrences of rheumatic fever, the adequacy of one set of guidelines (the current Jones criteria) for the diagnosis of rheumatic fever both in developed countries and in developing countries that have a much higher prevalence of rheumatic fever, and monoarticular arthritis as a possible major criterion for the diagnosis of rheumatic fever. The working group reaffirmed the validity …