<< Acute Rheumatic Fever: An Evidence-Based Approach to Diagnosis and Initial Management (Pharmacology CME)

Emergency Department Evaluation

There is no single laboratory test that can confirm the diagnosis of ARF. As a result, the diagnosis of ARF remains a clinical one, and the diagnosis relies on a thorough evaluation by healthcare professionals. Many clinicians have never seen a case of ARF, as the disease has largely disappeared from the United States (other than clusters of attacks in certain ethnic groups or regions). As a result, it has become even more important to be aware of the diagnostic criteria that have been established to aid clinicians in the diagnosis of the initial presentation of rheumatic fever.

The Jones Criteria

The initial criteria for establishing the diagnosis of ARF, the Jones criteria, were introduced in 1944.26 The clinical features of ARF were divided into major and minor manifestations based on the prevalence and specificity of the manifestation. Major manifestations make the diagnosis more likely, whereas mi-nor manifestations, while suggestive of the disease, are insufficient alone to make the diagnosis of ARF.

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