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Jones Criteria for Rheumatic Fever Diagnosis

Calculators  Multiple body systems
Jones Criteria for Acute Rheumatic Fever Diagnosis is effective tool utilized for the diagnosis of acute rheumatic fever
Positive throat culture or rapid strep test
No 0
Yes 100.5
Elevated or rising streptococcal antibody titer
No 0
Yes 200.5
Carditis
No 0
Yes 10
Polyarthritis
No 0
Yes 20
Chorea
No 0
Yes 30
Erythema marginatum
No 0
Yes 40
Subcutaneous nodules
No 0
Yes 50
Arthralgia
No 0
Yes 1
Fever
No 0
Yes 1
Elevated acute phase reactants
No 0
Yes 1
Erythrocyte sedimentation rate
No 0
Yes 1
C-reactive protein
No 0
Yes 1
Prolonged PR interval
No 0
Yes 1
Result:

Background

Measured Factor
Jones Criteria
Measured Factor Disease
  • Acute Rheumatic Fever
Measured Factor Detail
Jones Criteria for Acute Rheumatic Fever Diagnosis is used in initial attacks of acute rheumatic fever. It never measures the rheumatic activity.The calculation takes into account patient features such as major and minor criterion either the presence of chorea, polyarthritis, carditis, subcutaneous nodules, fever, arthralgia, C-reactive protein and prolonged PR interval.
Speciality
Rheumatologist
Body System
Multiple body systems
Measured Factor Low Impact
  • Positive diagnosis of acute rheumatic fever shows low risk level
Measured Factor High Impact
  • Negative diagnosis of acute rheumatic fever shows high risk level

Result Interpretation

Ranges Ranges
Test Limitations
An important limitation of Modified Jones’criteria is that it is not useful for the diagnosis of recurrences of rheumatic fever.
References: 2

Studies

Study Validation 1
A prospective cohort study was conducted on 2,919 patients above the age of 50 years, with rheumatic heart disease undergoing heart valve surgery to demonstrate that rheumatic heart valve surgery score (RheSCORE) model provides a substantially improved predictive performance over previous scores. To predict mortality risk, some important variables were included such as high creatinine, left atrium size, the presence of pulmonary hypertension, a tricuspid procedure, and a reoperation procedure. The areas under the curve were determined by using Random Forest (0.982) and Neural Network (0.952) models and the results of the study depicted that the areas under the curve were all below the performance for the RheSCORE model for previously developed scores.
References: 3
Study Validation 2
A retrospective study was conducted on 81 children and adolescents with acute rheumatic fever (ARF) to assess the reliability of the Jones criteria. Chorea was reported in 28 (34.6%) patients and the girls were more affected by it. The outcomes of the study reported that about 29.6% patients accomplished revised Jones criteria for ARF involving an evidence of previous group-A streptococcal infection (GASI).
References: 4
Study Additional 1
The study was conducted on 367 people to evaluate the Jones criteria in many developing countries and to illustrate the clinical features of rheumatic fever. The outcome of the study found that around 13% of cases of arthritis in rheumatic fever were monoarticular in India. About 58% of them eventually developed rheumatic heart disease in cases of chorea. In the Aboriginal population, there was a higher rate of recurrent acute rheumatic fever. The study concluded that low-grade fever and monoarthritis were important indications of rheumatic fever in the Aboriginal population.
References: 5
Study Additional 2
A prospective study was conducted on 151 children up to 15 years of age with acute rheumatic fever (ARF) to identify the patterns of disease, regions at highest risk and population across Australia. The major manifestation was aseptic monoarthritis in 19% of high-risk children and Sydenham chorea was also reported in them. The outcomes of the study illustrated that these data should bring about an awareness of ARF diagnosis and management over all the regions.
References: 6
Study Additional 3
A systematic review and prospective studies from 10 countries on all continents, except Africa were conducted with a mean (SD) of 6 (3.6) years, to determine the incidence of the first attack of acute rheumatic fever (ARF) in the world by using Duckett–Jones criteria. For each study, the overall mean incidence rate of the first attack of ARF calculated over the entire study period was 5-51/100,000 population (mean 19/100,000; 95% CI 9 to 30/100,000). While a higher overall mean annual incidence rate of 51/100 000 was reported in India. The study concluded that ARF incidence rates persist relatively high in non-Western countries.
References: 7

References

  1. Dajani AS, Ayoub E, Bierman FZ, et al. Guidelines for the Diagnosis of Rheumatic FeverJones Criteria, 1992 Update. JAMA. 1992;268(15):2069–2073.
  2. Pereira BÁF, Belo AR, Silva NAD. Rheumatic fever: update on the Jones criteria according to the American Heart Association review - 2015. Rev Bras Reumatol Engl Ed. 2017;57(4):364-368.
  3. Mejia OAV, Antunes MJ, Goncharov M, Dallan LRP, Veronese E, Lapenna GA, et al. Predictive performance of six mortality risk scores and the development of a novel model in a prospective cohort of patients undergoing valve surgery secondary to rheumatic fever. Bachschmid MM, ed. PLoS ONE. 2018;13(7):e0199277.
  4. Pereira BA, Da silva NA, Andrade LE, Lima FS, Gurian FC, De almeida netto JC. Jones criteria and underdiagnosis of rheumatic fever. Indian J Pediatr. 2007;74(2):117-21.
  5. Carapetis J, Currie B. Rheumatic fever in a high incidence population: the importance of monoarthritis and low grade fever. Archives of Disease in Childhood. 2001;85(3):223-227.
  6. Noonan S, Zurynski YA, Currie BJ, McDonald M, Wheaton G, Nissen M et al. A national prospective surveillance study of acute rheumatic fever in Australian children. Pediatr Infect Dis J. 2013;32(1):e26-32.
  7. Tibazarwa KB, Volmink JA, Mayosi BM. Incidence of acute rheumatic fever in the world: a systematic review of population-based studies. Heart. 2008;94(12):1534-40.