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.
Total Score |
Duration of Observation |
Diagnosis |
>= 10 |
>= 6 months |
definite |
>= 10 |
>= 3 months (12 weeks) |
probable |
Purpose: To evaluate a patient for adult onset Still's disease using the criteria of Cush et al.
Specialty: Immunology/Rheumatology
Objective: criteria for diagnosis
ICD-10: M06.1,