A 42-year-old woman presents with symmetric polyarthritis of the hands and feet for 6 weeks. Anti-CCP antibody is strongly positive. Rheumatoid factor is negative. ESR is 52 mm/hr. Per the 2010 ACR/EULAR classification criteria, which statement is correct?
- A She cannot be classified as RA because RF is negative
- B She can be classified as definite RA based on joint involvement, serology, acute phase reactants, and duration ✓
- C Anti-CCP positivity alone is sufficient for RA diagnosis regardless of joint involvement
- D A positive anti-CCP is not part of the 2010 ACR/EULAR criteria
Correct answer: B. She can be classified as definite RA based on joint involvement, serology, acute phase reactants, and duration
Explanation
The 2010 ACR/EULAR criteria score joint involvement, serology (RF and anti-CCP), acute phase reactants (ESR/CRP), and symptom duration. Anti-CCP carries equal weight to RF in the serology domain. A score of 6 or more classifies definite RA. Seronegative RA with positive anti-CCP and typical joint involvement can meet criteria. Anti-CCP is explicitly included in the serology domain.
Reference: ARTHRITIS & RHEUMATISM (2010 ACR/EULAR Criteria), 2010 ed.
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