Description

ten Brinck et al reported a clinical rule for early recognition of inflammatory arthritis. A patient with possible early inflammatory arthritis should be referred to a rheumatologist in 3-6 weeks after onset. the authors are from Leiden University in The Netherlands.


Patient selection: recent onset of arthritis

 

Parameter:

(1) sex

(2) age in years

(3) duration of symptoms in weeks

(4) duration of morning stiffness in minutes

(5) number of patient-reported painful joints

(6) number of patient-reported joint swelling

(7) making a fist

 

Parameter

Finding

Points

sex

male

0.5

 

female

0

age in years

< 60 years

0

 

>= 60 years

0.5

duration of symptoms

< 6 weeks

1.5

 

6 to 51.9

1

 

>= 52

0

morning stiffness

<= 60 minutes

0

 

> 60 minutes

0.5

number of painful joints

0

0

 

1 to 3

2.5

 

>= 4

1.5

number of swollen joints

0

0

 

>= 1

1.5

making a fist

not difficult

0

 

difficult

0.5

 

total score =

= SUM(points for all 7 parameters)

 

Interpretation:

minimum score: 0

maximum score: 7.5

The higher the score the greater the risk of early inflammatory arthritis.

 

Score

Risk of Inflammatory Arthritis

0

0%

1

2%

2

8%

3

14%

4

30%

5

49%

6

71%

7

87%

 

Performance:

The area under the ROC curve is 0.74 in derivation set and 0.71 in validation set.


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