Clinical Arthritis Rule (CARE) of ten Brinck for Recognition of Early Inflammatory Arthritis

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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Clinical Arthritis Rule (CARE) of ten Brinck for Recognition of Early Inflammatory Arthritis

Description

Specialty