The 2022 ACR/EULAR criteria for rheumatoid arthritis require a score ≥ 6 for classification. A patient has 8 small joints involved (swollen/tender), positive high-titre anti-CCP, CRP 2× normal, and symptom duration of 7 weeks. What is the MINIMUM total score achieved in this scenario?

• A 5
• B 6
• C 8
• D 10 ✓

Explanation

Using the 2010 ACR/EULAR RA classification criteria (still referenced in Harrison's 21st): joint involvement ≥7 small joints scores 5 points; high-titre positive serology (anti-CCP >3× ULN) scores 3 points; abnormal acute phase reactant (elevated CRP/ESR) scores 1 point; symptom duration ≥6 weeks scores 1 point. Total = 5 + 3 + 1 + 1 = 10 points, well above the threshold of 6. This scenario clearly meets RA classification criteria.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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