Modified Jones criteria - Revision history

Aidan at 15:10, 19 February 2022

2022-02-19T15:10:21Z

Aidan: /* Interpretation */

2021-02-12T16:14:24Z

Interpretation

Aidan: added Further Reading

2020-07-19T12:37:53Z

added Further Reading

Aidan: /* Criteria */

2020-07-19T12:35:26Z

Criteria

← Older revision		Revision as of 12:35, 19 July 2020
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	!Low-risk populations		!Low-risk populations
	!Moderate- and high-risk populations		!Moderate- and high-risk populations
			\|-
			! colspan="2" \|Preceding infection
			\|-
			\| colspan="2" \|Increased/rising ASOT or anti-DNASE B
			\|-
			\| colspan="2" \|Positive throat culture
			\|-
			\| colspan="2" \|Positive rapid antigen test in a classic case
	\|-		\|-
	! colspan="2" \|Major criteria		! colspan="2" \|Major criteria

Aidan: Fixed interpretation section and added preceding infection section

2020-07-19T12:34:03Z

Fixed interpretation section and added preceding infection section

← Older revision		Revision as of 12:34, 19 July 2020
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	*Used to diagnose [[acute rheumatic fever]]		*Used to diagnose [[acute rheumatic fever]]

	== Criteria ==		==Criteria==
	{\| class="wikitable"		{\| class="wikitable"
	\|+
	!Low-risk populations		!Low-risk populations
	!Moderate- and high-risk populations		!Moderate- and high-risk populations
	\|-		\|-
	!colspan=2\|Major criteria		! colspan="2" \|Major criteria
	\|-		\|-
	\|Carditis (clinical or subclinical)		\|Carditis (clinical or subclinical)
Line 24:		Line 23:
	\|Subcutaneous nodules		\|Subcutaneous nodules
	\|-		\|-
	!colspan=2\|Minor criteria		! colspan="2" \|Minor criteria
	\|-		\|-
	\|Polyarthralgia (without arthritis)		\|Polyarthralgia (without arthritis)
Line 38:		Line 37:
	\|Prolonged PR interval (without carditis)		\|Prolonged PR interval (without carditis)
	\|}		\|}
⚫	* Low-risk = ≤2 cases of acute rheumatic fever per 100,000 school-aged children, or ≤1 case of rheumatic heart disease per 1000 people of any age

		⚫	*Low-risk = ≤2 cases of acute rheumatic fever per 100,000 school-aged children, or ≤1 case of rheumatic heart disease per 1000 people of any age
⚫	=== Major criteria ===

			=== Preceding ''Streptococcus pyogenes'' infection ===

			* The diagnosis of acute rheumatic fever requires evidence of preceding streptococcal infection, as indicated by one of the following:
			** Increased or rising anti-streptolysin O titre, or other streptococcal antibody such as anti-DNASE B; a rising titre is considered stronger evidence
			** A positive throat culture for [[Streptococcus pyogenes]]
			** A positive rapid streptococcal antigen test in a child whose clinical presentation suggests a high pretest probability of streptococcal pharyngitis

		⚫	===Major criteria===

	*Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.		*Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
Line 48:		Line 55:
	*Sydenham's chorea (St. Vitus' dance): A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.		*Sydenham's chorea (St. Vitus' dance): A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.

	=== Minor criteria ===		===Minor criteria===

	*Fever		*Fever
	*Arthralgia: joint pain without swelling (cannot be included if arthritis is present as a major symptom)		*Arthralgia: joint pain without swelling (cannot be included if arthritis is present as a major symptom)
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	*ECG showing features of heart block, such as a prolonged PR interval (cannot be included if carditis is present as a major symptom)		*ECG showing features of heart block, such as a prolonged PR interval (cannot be included if carditis is present as a major symptom)

	== Interpretation ==		==Interpretation==

			*'''Initial acute rheumatic fever'''
⚫	**~~Two of the~~ major criteria
			**Evidence of preceding [[Streptococcus pyogenes]] infection, plus either:
⚫	**~~One~~ major criterion ~~plus~~ ~~two~~ minor criteria
		⚫	**2 major criteria, or
		⚫	**1 major criterion and 1 minor criteria
			*'''Recurrent acute rheumatic fever'''
			**Evidence of preceding [[Streptococcus pyogenes]] infection, plus one of:
			**2 major criteria, or
			**1 major criterion and 2 minor criteria, or
			**3 minor criteria
			*'''Possible acute rheumatic fever'''
			**Not meeting above criteria but high clinical suspicion

	[[Category:Infectious diseases]]		[[Category:Infectious diseases]]

Aidan at 12:24, 19 July 2020

2020-07-19T12:24:42Z

← Older revision		Revision as of 12:24, 19 July 2020
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	* Used to diagnose [[acute rheumatic fever]]		*Used to diagnose [[acute rheumatic fever]]

⚫	* ~~'''~~Major criteria~~'''~~
			== Criteria ==
⚫	** Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
			{\| class="wikitable"
⚫	** Carditis: Inflammation of the heart muscle (myocarditis) which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur.
			\|+
⚫	** Subcutaneous nodules: Painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.
			!Low-risk populations
⚫	** Erythema marginatum: A long-lasting reddish rash that begins on the trunk or arms as macules, which spread outward and clear in the middle to form rings, which continue to spread and coalesce with other rings, ultimately taking on a snake-like appearance. This rash typically spares the face and is made worse with heat.
			!Moderate- and high-risk populations
⚫	** Sydenham's chorea (St. Vitus' dance): A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.
			\|-
⚫	* ~~'''~~Minor criteria~~'''~~
			!colspan=2\|Major criteria
	** Fever of 38.2–38.9 °C (100.8–102.0 °F)
			\|-
⚫	** Arthralgia: ~~Joint~~ pain without swelling (~~Cannot~~ be included if ~~polyarthritis~~ is present as a major symptom)
			\|Carditis (clinical or subclinical)
⚫	** Raised erythrocyte sedimentation rate or C reactive protein
			\|Carditis (clinical or subclinical)
	** Leukocytosis
			\|-
⚫	** ECG showing features of heart block, such as a prolonged PR interval~~[31][33]~~ (~~Cannot~~ be included if carditis is present as a major symptom)
			\|Arthritis (polyarthritis)
	** Previous episode of rheumatic fever or inactive heart disease
			\|Arthritis (monoarthritis, polyarthritis, or polyarthralgia)
⚫	* Interpretation
			\|-
⚫	** Two of the major criteria
			\|Chorea
⚫	** One major criterion plus two minor criteria
			\|Chorea
			\|-
			\|Erythema marginatum
			\|Erythema marginatum
			\|-
			\|Subcutaneous nodules
			\|Subcutaneous nodules
			\|-
			!colspan=2\|Minor criteria
			\|-
			\|Polyarthralgia (without arthritis)
			\|Monoarthralgia (without arthritis)
			\|-
			\|Fever ≥38.5ºC
			\|Fever ≥38ºC
			\|-
			\|ESR ≥60 mm/h or CRP ≥3 mg/dL
			\|ESR ≥30 mm/h or CRP ≥3 mg/dL
			\|-
			\|Prolonged PR interval (without carditis)
			\|Prolonged PR interval (without carditis)
			\|}
			* Low-risk = ≤2 cases of acute rheumatic fever per 100,000 school-aged children, or ≤1 case of rheumatic heart disease per 1000 people of any age

		⚫	=== Major criteria ===

		⚫	*Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
		⚫	*Carditis: Inflammation of the heart muscle (myocarditis) which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur. This includes subclinical carditis suggested by valvulitis on echo.
		⚫	*Subcutaneous nodules: Painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.
		⚫	*Erythema marginatum: A long-lasting reddish rash that begins on the trunk or arms as macules, which spread outward and clear in the middle to form rings, which continue to spread and coalesce with other rings, ultimately taking on a snake-like appearance. This rash typically spares the face and is made worse with heat.
		⚫	*Sydenham's chorea (St. Vitus' dance): A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.

		⚫	=== Minor criteria ===
			*Fever
		⚫	*Arthralgia: joint pain without swelling (cannot be included if arthritis is present as a major symptom)
		⚫	*Raised erythrocyte sedimentation rate or C reactive protein
		⚫	*ECG showing features of heart block, such as a prolonged PR interval (cannot be included if carditis is present as a major symptom)

		⚫	== Interpretation ==

		⚫	**Two of the major criteria
		⚫	**One major criterion plus two minor criteria

			[[Category:Infectious diseases]]

Aidan: Created page with "* Used to diagnose acute rheumatic fever * '''Major criteria''' ** Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and..."

2019-09-12T13:18:27Z

Created page with "* Used to diagnose acute rheumatic fever * '''Major criteria''' ** Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and..."

New page

* Used to diagnose [[acute rheumatic fever]]
* '''Major criteria'''
** Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
** Carditis: Inflammation of the heart muscle (myocarditis) which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur.
** Subcutaneous nodules: Painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.
** Erythema marginatum: A long-lasting reddish rash that begins on the trunk or arms as macules, which spread outward and clear in the middle to form rings, which continue to spread and coalesce with other rings, ultimately taking on a snake-like appearance. This rash typically spares the face and is made worse with heat.
** Sydenham's chorea (St. Vitus' dance): A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.
* '''Minor criteria'''
** Fever of 38.2–38.9 °C (100.8–102.0 °F)
** Arthralgia: Joint pain without swelling (Cannot be included if polyarthritis is present as a major symptom)
** Raised erythrocyte sedimentation rate or C reactive protein
** Leukocytosis
** ECG showing features of heart block, such as a prolonged PR interval[31][33] (Cannot be included if carditis is present as a major symptom)
** Previous episode of rheumatic fever or inactive heart disease
* Interpretation
** Two of the major criteria
** One major criterion plus two minor criteria

← Older revision		Revision as of 15:10, 19 February 2022
Line 48:		Line 48:
	*Low-risk = ≤2 cases of acute rheumatic fever per 100,000 school-aged children, or ≤1 case of rheumatic heart disease per 1000 people of any age		*Low-risk = ≤2 cases of acute rheumatic fever per 100,000 school-aged children, or ≤1 case of rheumatic heart disease per 1000 people of any age

	===Preceding ''Streptococcus pyogenes'' ~~infection~~===		===Preceding ''Streptococcus pyogenes'' Infection===

	*The diagnosis of acute rheumatic fever requires evidence of preceding streptococcal infection, as indicated by one of the following:		*The diagnosis of acute rheumatic fever requires evidence of preceding streptococcal infection, as indicated by one of the following:
Line 55:		Line 55:
	**A positive rapid streptococcal antigen test in a child whose clinical presentation suggests a high pretest probability of streptococcal pharyngitis		**A positive rapid streptococcal antigen test in a child whose clinical presentation suggests a high pretest probability of streptococcal pharyngitis

	===Major ~~criteria~~===		===Major Criteria===

	*Polyarthritis: A temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.		*'''Polyarthritis:''' A temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
	*Carditis: Inflammation of the heart muscle (myocarditis) which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur. This includes subclinical carditis suggested by valvulitis on echo.		*'''Carditis:''' Inflammation of the heart muscle (myocarditis) which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur. This includes subclinical carditis suggested by valvulitis on echo.
	*Subcutaneous nodules: Painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.		*'''Subcutaneous nodules:''' Painless, firm collections of collagen fibers over bones or tendons. They commonly appear on the back of the wrist, the outside elbow, and the front of the knees.
	*Erythema marginatum: A long-lasting reddish rash that begins on the trunk or arms as macules, which spread outward and clear in the middle to form rings, which continue to spread and coalesce with other rings, ultimately taking on a snake-like appearance. This rash typically spares the face and is made worse with heat.		*'''Erythema marginatum:''' A long-lasting reddish rash that begins on the trunk or arms as macules, which spread outward and clear in the middle to form rings, which continue to spread and coalesce with other rings, ultimately taking on a snake-like appearance. This rash typically spares the face and is made worse with heat.
	*Sydenham's chorea (St. Vitus' dance): A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.		*'''Sydenham's chorea (St. Vitus' dance):''' A characteristic series of involuntary rapid movements of the face and arms. This can occur very late in the disease for at least three months from onset of infection.

	===Minor ~~criteria~~===		===Minor Criteria===

	*Fever		*'''Fever'''
	*Arthralgia: joint pain without swelling (cannot be included if arthritis is present as a major symptom)		*'''Arthralgia:''' joint pain without swelling (cannot be included if arthritis is present as a major symptom)
	*~~Raised~~ erythrocyte sedimentation rate or C reactive protein		*'''Evidence of inflammation:''' raised erythrocyte sedimentation rate or C reactive protein
	*ECG showing features of heart block, such as a prolonged PR interval (cannot be included if carditis is present as a major symptom)		*'''Heart block:''' ECG showing features of heart block, such as a prolonged PR interval (cannot be included if carditis is present as a major symptom)

	==Interpretation==		==Interpretation==

← Older revision		Revision as of 16:14, 12 February 2021
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	*'''Initial acute rheumatic fever'''		*'''Initial acute rheumatic fever'''
	**Evidence of preceding [[Streptococcus pyogenes]] infection, plus either:		**Evidence of preceding [[Streptococcus pyogenes]] infection, plus either:
	**2 major criteria, or		***2 major criteria, or
	**1 major criterion and 1 minor criteria		***1 major criterion and 1 minor criteria
	*'''Recurrent acute rheumatic fever'''		*'''Recurrent acute rheumatic fever'''
	**Evidence of preceding [[Streptococcus pyogenes]] infection, plus one of:		**Evidence of preceding [[Streptococcus pyogenes]] infection, plus one of:
	**2 major criteria, or		***2 major criteria, or
	**1 major criterion and 2 minor criteria, or		***1 major criterion and 2 minor criteria, or
	**3 minor criteria		***3 minor criteria
	*'''Possible acute rheumatic fever'''		*'''Possible acute rheumatic fever'''
	**Not meeting above criteria but high clinical suspicion		**Not meeting above criteria but high clinical suspicion

	== Further Reading ==		==Further Reading==

	* Revision of the Jones Criteria for the Diagnosis of Acute Rheumatic Fever in the Era of Doppler Echocardiography. ''Circulation''. 2015;131:1806-1818. doi: [https://doi.org/10.1161/CIR.0000000000000205 10.1161/CIR.0000000000000205]		*Revision of the Jones Criteria for the Diagnosis of Acute Rheumatic Fever in the Era of Doppler Echocardiography. ''Circulation''. 2015;131:1806-1818. doi: [https://doi.org/10.1161/CIR.0000000000000205 10.1161/CIR.0000000000000205]

	[[Category:Infectious diseases]]		[[Category:Infectious diseases]]

← Older revision		Revision as of 12:37, 19 July 2020
Line 48:		Line 48:
	*Low-risk = ≤2 cases of acute rheumatic fever per 100,000 school-aged children, or ≤1 case of rheumatic heart disease per 1000 people of any age		*Low-risk = ≤2 cases of acute rheumatic fever per 100,000 school-aged children, or ≤1 case of rheumatic heart disease per 1000 people of any age

	=== Preceding ''Streptococcus pyogenes'' infection ===		===Preceding ''Streptococcus pyogenes'' infection===

	* The diagnosis of acute rheumatic fever requires evidence of preceding streptococcal infection, as indicated by one of the following:		*The diagnosis of acute rheumatic fever requires evidence of preceding streptococcal infection, as indicated by one of the following:
	** Increased or rising anti-streptolysin O titre, or other streptococcal antibody such as anti-DNASE B; a rising titre is considered stronger evidence		**Increased or rising anti-streptolysin O titre, or other streptococcal antibody such as anti-DNASE B; a rising titre is considered stronger evidence
	** A positive throat culture for [[Streptococcus pyogenes]]		**A positive throat culture for [[Streptococcus pyogenes]]
	** A positive rapid streptococcal antigen test in a child whose clinical presentation suggests a high pretest probability of streptococcal pharyngitis		**A positive rapid streptococcal antigen test in a child whose clinical presentation suggests a high pretest probability of streptococcal pharyngitis

	===Major criteria===		===Major criteria===
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	*'''Possible acute rheumatic fever'''		*'''Possible acute rheumatic fever'''
	**Not meeting above criteria but high clinical suspicion		**Not meeting above criteria but high clinical suspicion

			== Further Reading ==

			* Revision of the Jones Criteria for the Diagnosis of Acute Rheumatic Fever in the Era of Doppler Echocardiography. ''Circulation''. 2015;131:1806-1818. doi: [https://doi.org/10.1161/CIR.0000000000000205 10.1161/CIR.0000000000000205]

	[[Category:Infectious diseases]]		[[Category:Infectious diseases]]