Signs and Evidence

Making clinical sense of scientific data


Beware of the limitations of this tool

Rheumatoid arthritis

Calculated pretest probability: 0.45 %
Relevant inclusion criteria: All adults 


1Morning stiffness

Clinical signs

2Swelling in wrists
3Swelling in MCPs
4Swelling in PIPs
5Swelling in DIPs
6Swelling in ankles
7Swelling in elbows
8Pain on motion in MCPs
9Pain on motion in wrists
10Pain on motion in elbows
11Swelling in knees
12Pain on motion in ankles
13Pain on motion in PIPs
14Pain on motion in shoulders
15Pain on motion in knees
16Pain on motion in hips
17Pain on motion in DIPs

To further investigations

Sources used:

1.Arnett FC et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-24.
2.Nishimura K et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med. 2007 Jun 5;146(11):797-808
3.Rindfleisch JA et al. Diagnosis and Management of Rheumatoid Arthritis. Am Fam Physician. 2005 Sep 15;72(6):1037-1047
4.Payet J et al. Anticyclic Citrullinated Peptide Antibodies in Rheumatoid and Nonrheumatoid Rheumatic Disorders: Experience with 1162 Patients. The Journal of Rheumatology 41(12) · October 2014
5.Miller A et al. Estimating the diagnostic accuracy of rheumatoid factor in UK primary care: a study using the Clinical Practice Research Datalink. Rheumatology, Volume 54, Issue 10, 1 October 2015, Pages 1882–1889
6.Carmona L et al. The prevalence of rheumatoid arthritis in the general population of Spain. Rheumatology (Oxford). 2002 Jan;41(1):88-95
7.Riise T et al. Incidence and prevalence of rheumatoid arthritis in the county of Troms, northern Norway. J Rheumatol. 2000 Jun;27(6):1386-9
8.Cimmino M et al. Prevalence of rheumatoid arthritis in Italy: the Chiavari study. Ann Rheum Dis. 1998 May; 57(5): 315–318