Modified Jones Criteria for a First Episode of Acute Rheumatic Fever (ARF)*
Manifestations | Specific Finding |
|---|---|
Major | Carditis† Chorea Erythema marginatum Polyarthritis Subcutaneous nodules |
Minor | Polyarthralgia‡ Elevated erythrocyte sedimentation rate (> 60 mm/hour) or C-reactive protein (> 30 mg/L [> 285.7 nmol/L]) Fever (≥ 38.5° C) Prolonged PR interval (on ECG)§ |
* Diagnosis of ARF requires 2 major or 1 major and 2 minor manifestations and evidence of group A streptococcal infection (elevated or rising antistreptococcal antibody titer [eg, antistreptolysin O, anti-DNase B], positive throat culture, or positive rapid antigen test in a child with clinical manifestations suggestive of streptococcal pharyngitis). | |
† Carditis can be clinical and/or subclinical. Subclinical carditis is defined by strict echocardiographic criteria. | |
‡ Polyarthralgia is not used for diagnosis if polyarthritis is a major criterion for the patient. | |
§ PR interval is adjusted for age and is not used for diagnosis if carditis is a major criterion for the patient. | |
Data from Gewitz MH, Baltimore RS, Tani LY, et al: Revision of Jones criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: A scientific statement from the American Heart Association. Circulation 131:1806–1818, 2015. doi: 10.1161/CIR.0000000000000205 | |