ACR/EULAR RA Criteria (2010)

Classification of rheumatoid arthritis — score ≥ 6/10 classifies definite RA

Apply only to patients with at least one joint with definite clinical synovitis not better explained by another disease.

Joint involvement

1 large joint

2–10 large joints

1–3 small joints (± large joints)

4–10 small joints (± large joints)

> 10 joints (at least 1 small joint)

Serology (RF and/or ACPA)

Negative RF and negative ACPA

Low-positive RF or low-positive ACPA (≤ 3× ULN)

High-positive RF or high-positive ACPA (> 3× ULN)

Acute-phase reactants (CRP and/or ESR)

Normal CRP and normal ESR

Abnormal CRP or abnormal ESR

Duration of symptoms

< 6 weeks

≥ 6 weeks

Answer all four domains

Evidence

Original publication

Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid Arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. A score-based algorithm (joint distribution, serology, acute-phase reactants, symptom duration) with ≥ 6/10 classifying definite RA, designed to identify patients earlier than the 1987 criteria.

Arthritis & Rheumatism, 2010

Open source

Guideline

These are classification criteria for research cohorts, applied only to patients with at least one joint with clinical synovitis not better explained by another disease (e.g. psoriatic arthritis, gout, SLE). "Small joints" are MCP, PIP, thumb IP, MTP 2–5 and wrists; DIP joints, first CMC and first MTP are excluded. Patients with erosive disease typical of RA, or long-standing disease previously meeting the criteria, can also be classified. It supports but does not replace clinical diagnosis.

Last reviewed: 2026-09

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