Adult Onset Still Disease | Medical Algorithm

Cush et al developed criteria for the diagnosis of adult onset Still's disease.

Parameters:

(1) age at onset

(2) arthritis

(3) prodromal sore throat

(4) reticuloendothelial system or liver function tests

(5) serositis

(6) cervical or tarsal ankylosis

(7) carpal ankylosis

(8) fever

(9) typical evanescent rash

(10) WBC count and erythrocyte sedimentation rate

(11) rheumatoid factor and ANA

Parameter	Finding	Points
age at onset	< 35 years of age	1
	>= 35 years of age	0
arthritis	absent	0
	present	1
prodromal sore throat	absent	0
	present	1
reticuloendothelial system and/or liver function tests	neither	0
	either or both abnormal	1
serositis	absent	0
	present	1
cervical or tarsal ankylosis	absent	0
	present	1
carpal ankylosis	absent	0
	present	2
fever	quotidian > 39°C	2
	other	0
typical evanescent rash	absent	0
	present	2
WBC count and ESR	WBC count > 12,000 per µL AND ESR > 40 mm in first hour	2
	either or neither	0
rheumatoid factor and ANA	both negative	2
	either positive	0

where:

• Quotidian fever = daily fever

total score =

= SUM(points for all 11 parameters)

Interpretation:

• minimum score: 0

• maximum score: 16

• The higher the score the more likely the patient has adult onset Still's disease.

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Criteria for Adult Onset Still's Disease