Major Jones’ Criteria: JONES

  • JJoint involvement (polyarthritis) which is usually migratory and inflammatory joint involvement that starts in the lower joints and ascends to upper joints
  • OOffended Heart –i.e. myocarditis or inflammation of the heart – new murmur.
  • NNodules under the skin (subcutaneous nodules)
  • EErythema marginatum which is a rash of ring-like lesions that can start in the trunk or arms. When joined with other rings, it can create a snake-like appearance
  • SSydenham chorea is a late feature which is characterized by jerky, uncontrollable, and purposeless movements resembling twitches

Minor criteria: HEART

  • H- Heart ECG showing prolonged PR intervals.
  • E- ESR or CRP elevation. These are acute phase reactants.
  • A- Arthralgias (not arthritis),
  • R- Rheumatic fever in the past, i.e. history of rheumatic heart disease.
  • T- Temperature increase (Fever)

Diagnosis: Diagnosis of rheumatic fever is made after a strep infection indicated by either throat cultures growing GABHS OR positive rapid antigen test, OR elevated antistreptolysin O (ASO) titers in the blood) and:

  • Two major criteria OR
  • One major criterion and two minor criteria

** Evidence of recent streptococcal infection is required to confirm the diagnosis. This can be accomplished by detecting an elevated or rising ASO titer or by obtaining a positive throat culture or rapid Strep antigen test or recent scarlet fever.

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