A 48-year-old woman presents with symmetric polyarthritis of the hands and wrists for 12 weeks. According to the 2010 ACR/EULAR classification criteria for rheumatoid arthritis, a score of 6 or more out of 10 is required for definite diagnosis. Involvement of more than 10 joints (at least one small joint) scores the maximum in the joint domain. What is the maximum score assigned to the serology domain (RF and anti-CCP)?
- A 1 point
- B 2 points
- C 3 points ✓
- D 5 points
Correct answer: C. 3 points
Explanation
The 2010 ACR/EULAR RA classification criteria allocate a maximum of 3 points to the serology domain: high-positive RF or high-positive anti-CCP (>3 times upper normal limit) scores 3 points, while low-positive versions score 2 points. The total score across four domains (joint involvement, serology, acute-phase reactants, duration) must be 6 or more out of 10 for classification as definite RA.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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