The Value of the ACR 1987 Criteria in Very Early Rheumatoid Arthritis

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Abstract
We assessed the sensitivity and specificity of the ACR 1987 revised criteria for rheumatoid arthritis (RA) in 121 patients with recent-onset (≤6 months) RA, 68 with reactive arthritis (ReA), 19 with ankylosing spondylitis (AS), and 13 with psoriatic arthritis (PsA). The sensitivity of each single criterion ranged 8.3–90.9% and specificity 52.0–100%. The sensitivity of four fulfilled criteria was 83.5% and specificity 86.0%. In ReA 11.8%, AS 5.3%, and PsA 38.5% of patients fulfilled four criteria respectively. Thus at the beginning of RA, 83% of patients could be diagnosed correctly by using the ACR 1987 criteria, and the remaining 17% had seropositive andor erosive arthritis at the onset. The suitability of the radiographic ACR criteria is discussed.