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Rheumatoid Arthritis — SCE Rheumatology MCQ

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EasyRheumatoid ArthritisRheumatoid ArthritisSCE Rheumatology

A patient has clinically confirmed synovitis in at least one joint, with no alternative diagnosis that better explains the synovitis. Under the 2010 ACR/EULAR rheumatoid arthritis classification criteria, what is the minimum total score required to classify the patient as having definite rheumatoid arthritis?

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Correct answer: E — 6

The correct answer is E: 6. In an eligible patient—one with definite clinical synovitis in at least one joint and no better alternative diagnosis—a total score of at least 6 out of 10 classifies definite rheumatoid arthritis. Points are awarded for joint involvement (0–5), RF or ACPA serology (0–3), acute-phase reactants (0–1), and symptom duration (0–1). Scores of 4 or 5 are below the classification threshold, while 7 or 8 would qualify but are not the minimum. RF and anti-CCP positivity are assessed within a single serology domain rather than scored independently, and the score depends on whether the antibody level is low-positive or high-positive.

Reference: Aletaha D, et al. 2010 rheumatoid arthritis classification criteria: an ACR/EULAR collaborative initiative. Annals of the Rheumatic Diseases. 2010;69:1580–1588. https://pubmed.ncbi.nlm.nih.gov/20699241/