Master Table of Rheumatological Diseases PDF

### **Master Table of Standard Diagnostic Criteria and Scoring Systems for Rheumatological Diseases** **Rheumatological Disease** **Diagnostic Criteria**...

### **Master Table of Standard Diagnostic Criteria and Scoring Systems for Rheumatological Diseases** **Rheumatological Disease** **Diagnostic Criteria** **Scoring System** **Key Features** --------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------ **Rheumatoid Arthritis (RA)** \- **Joint involvement**: At least **1 small joint** (hands/feet) **ACR/EULAR Criteria (≥6 points for diagnosis)** \- Swelling/tenderness in **≥3 joints** \- **Serology**: Positive **Rheumatoid Factor (RF)** and/or **Anti-Citrullinated Protein Antibody (ACPA)** \- **Joint Involvement**: 0-5 points \- Morning stiffness **\>1 hour**, especially in the morning \- **Acute-phase reactants**: Elevated **ESR** and/or **CRP** \- **Serology**: 0-3 points (e.g., RF/ACPA positivity) \- **Symptom duration ≥6 weeks** \- **Symptom duration**: Must be **≥6 weeks** \- **Acute-phase Reactants**: 0-1 point (based on ESR/CRP levels) **Diagnosis**: ≥6 points based on combination of above criteria **Systemic Lupus Erythematosus (SLE)** \- **Malar rash**, **discoid rash**, **photosensitivity**, **oral ulcers**, **arthritis** (nonerosive) **SLICC Criteria** (≥4 criteria, with at least **1 clinical** and **1 immunological** criterion) \- **Positive ANA** (Antinuclear Antibody) is almost always positive \- **Renal involvement**: e.g., lupus nephritis (proteinuria, hematuria) **Immunological Criteria**: **Anti-dsDNA**, **Anti-Smith**, **Anti-Ro**, **Anti-La**, and **low complement (C3, C4)** \- **Neuropsychiatric symptoms** (e.g., seizures, psychosis) \- **Immunological markers**: Positive **ANA**, **anti-dsDNA**, **anti-Smith**, **anti-Ro/La** \- **Serositis** (pleuritis, pericarditis) **Diagnosis**: ≥4 criteria with at least **1 clinical** (e.g., rash, oral ulcers) and **1 immunological** (e.g., positive ANA) **Ankylosing Spondylitis (AS)** \- **Chronic back pain** and **morning stiffness** (improves with physical activity) **New York Criteria** for **Established AS**: Must have **radiographic sacroiliitis** and **3 out of 5 features** \- **Sacroiliitis** on X-ray or MRI, as evidence of inflammation in the sacroiliac joints \- **Sacroiliitis** on imaging (X-ray or MRI) \- **Spinal Mobility**: Limited spinal movement (for spinal involvement) \- **HLA-B27 positivity** is commonly found, but not required for diagnosis \- **Limited spinal mobility**, with difficulty in forward bending and back extension \- **Chest Expansion**: Reduced chest expansion (normal is ≥5 cm) \- Persistent low back pain and limited spinal motion, often starting at young age and worse in the morning **Psoriatic Arthritis (PsA)** \- **Psoriasis** (skin lesions, family history of psoriasis) **CASPAR Criteria** (≥3 points required for diagnosis) \- **Dactylitis** (sausage-shaped fingers/toes) \- **Arthritis** involving joints, commonly fingers, toes, and spine \- Negative **Rheumatoid Factor (RF)** and **anti-CCP antibodies** \- **Negative RF** (Rheumatoid Factor), differentiates from RA \- Enthesitis (inflammation at tendon/ligament attachment sites) **Diagnosis**: ≥3 points from clinical, serological, and radiological findings **Gout** \- **Hyperuricemia** (serum uric acid **\>6.8 mg/dL**) **ACR/EULAR Gout Scoring** (≥8 points required for diagnosis) \- **Acute monoarthritis** or polyarthritis, especially in the **big toe** \- **Monosodium urate crystals** in synovial fluid (via joint aspiration) \- **Tophi** (urate crystals under skin) \- **Tophi** (can be visible as nodules under skin, especially around joints) **Diagnosis**: Based on high serum uric acid and presence of urate crystals in synovial fluid or tophi **Systemic Sclerosis (Scleroderma)** \- **Skin thickening** (especially on fingers, hands, and forearms) **ACR/EULAR Scleroderma Scoring** (≥9 points required for diagnosis) \- **Raynaud's phenomenon**: Impaired blood flow, especially in extremities \- **Raynaud\'s phenomenon** (triggered by cold or stress) \- **Positive anti-Scl-70** (for diffuse systemic sclerosis) \- **Positive autoantibodies**: Anti-Scl-70 (topoisomerase-1) and **anti-centromere** (for limited systemic sclerosis) \- **Pulmonary fibrosis** (lung involvement is common) \- **Gastrointestinal involvement** (esophageal dysmotility) **Sjögren's Syndrome** \- **Dry mouth** (xerostomia) and **dry eyes** (xerophthalmia), leading to difficulty swallowing and speaking **ACR/EULAR Scoring** (≥4 points required for diagnosis) \- **Positive ANA** and **anti-Ro (SSA)** and **anti-La (SSB)** antibodies \- **Schirmer\'s test** (for dry eyes) results **\10% on | | | | | criteria | blood | | | | | needed. | count. | | | | | | | | | | | | \- | | | | | | Mononeuriti | | | | | | s | | | | | | multiplex | | | | | | or | | | | | | polyneuropa | | | | | | thy. | | | | | | | | | | | | \- | | | | | | Sinusitis. | | | | | | | | | | | | \- | | | | | | Pulmonary | | | | | | infiltrates | | | | | |. | | | | | | | | | | | | \- Biopsy | | | | | | with | | | | | | granulomato | | | | | | us | | | | | | inflammatio | | | | | | n. | | +-------------+-------------+-------------+-------------+-------------+ +-------------+-------------+-------------+-------------+-------------+ | **IgA | Small | 1990 ACR | \- Palpable | **No formal | | Vasculitis | Vessel | Criteria | purpura, | scoring | | (Henoch-Sch | Vasculitis | for HSP: | predominant | system**; | | önlein | | Diagnosis | ly | Diagnosis | | Purpura)** | | based on | on the | is | | | | clinical | lower | clinical. | | | | features. | limbs. | | | | | | | | | | | | \- | | | | | | Abdominal | | | | | | pain or GI | | | | | | bleeding. | | | | | | | | | | | | \- Renal | | | | | | involvement | | | | | | (e.g., | | | | | | hematuria, | | | | | | proteinuria | | | | | | ). | | | | | | | | | | | | \- | | | | | | Arthritis/a | | | | | | rthralgia. | | +-------------+-------------+-------------+-------------+-------------+ +-------------+-------------+-------------+-------------+-------------+ | **Cryoglobu | Small | Clinical | \- | **No formal | | linemic | Vessel | and | Vasculitis | scoring | | Vasculitis* | Vasculitis | laboratory | with | system**; | | * | | criteria: | purpura, | Diagnosis | | | | Cryoglobuli | ulcers. | is clinical | | | | ns | | and | | | | in serum. | \- Positive | laboratory- | | | | | cryoglobuli | based. | | | | | ns. | | | | | | | | | | | | \- | | | | | | Hepatitis C | | | | | | virus | | | | | | association | | | | | | (in some | | | | | | cases). | | +-------------+-------------+-------------+-------------+-------------+ +-------------+-------------+-------------+-------------+-------------+ | **Behçet\'s | Small | 1990 | \- | **1990 | | Disease** | Vessel | Internation | Recurrent | Internation | | | Vasculitis | al | oral | al | | | | Study Group | ulcers. | Study Group | | | | Criteria: 4 | | Criteria**: | | | | out of 6. | \- Genital | Requires 4 | | | | | ulcers. | out of 6 | | | | | | criteria. | | | | | \- Eye | | | | | | lesions | | | | | | (e.g., | | | | | | uveitis, | | | | | | retinitis). | | | | | | | | | | | | \- Skin | | | | | | lesions | | | | | | (e.g., | | | | | | erythema | | | | | | nodosum). | | | | | | | | | | | | \- Positive | | | | | | pathergy | | | | | | test. | | +-------------+-------------+-------------+-------------+-------------+ +-------------+-------------+-------------+-------------+-------------+ | **Hypersens | Small | Clinical | \- Palpable | **No formal | | itivity | Vessel | diagnosis: | purpura on | scoring | | Vasculitis* | Vasculitis | Associated | the lower | system**; | | * | | with drug | limbs. | Diagnosis | | | | use, | | is clinical | | | | infections, | \- Symptoms | and | | | | or other | within 1-3 | histologica | | | | allergens. | weeks after | l. | | | | | exposure. | | | | | | | | | | | | \- | | | | | | Histologica | | | | | | l | | | | | | findings: | | | | | | leukocytocl | | | | | | astic | | | | | | vasculitis. | | +-------------+-------------+-------------+-------------+-------------+ --------------- -------------------- ------------------------------------------- -------------------- --------------------------- **Condition** **Scoring System** **Complete Criteria/Parameters & Scores** **Use/Indication** **Management Inferences** --------------- -------------------- ------------------------------------------- -------------------- --------------------------- +-------------+-------------+-------------+-------------+-------------+ | **Cirrhosis | **Child-Pug | **1. | **Prognosis | **Class A | | /Chronic | h | Bilirubin | ** | (5--6 | | Liver | Score** | (mg/dL)**: | and | points)**: | | Disease** | | | **severity | Well-compen | | | | 1 = \3 | of | **low-risk* | | | | | cirrhosis | * | | | | **2. | | for | | | | Albumin | | complicatio | | | | (g/dL)**: | | ns. | | | | | | | | | | 1 = \>3.5, | | **Class B | | | | 2 = | | (7--9 | | | | 2.8--3.5, 3 | | points)**: | | | | = \35 | | | | | | | | | | | | **5. | | | | | | Arterial | | | | | | pH**: | | | | | | | | | | | | 0 = | | | | | | 7.35--7.45, | | | | | | 4 = \ | | | | | | | 220)**: | | | | | | | **Urgent | | | | | | | coronary | | | | | | | intervent | | | | | | | ion**, | | | | | | | intensive | | | | | | | care, | | | | | | | consider | | | | | | | **intrave | | | | | | | nous | | | | | | | heparin** | | | | | | | or | | | | | | | **glycopr | | | | | | | otein | | | | | | | IIb/IIIa | | | | | | | inhibitor | | | | | | | s**. | +-----------+-----------+-----------+-----------+-----------+-----------+ | **TIMI | Acute | Criteria: | 0-7 | Estimates | \- 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