Friday, March 6, 2009


Diagnosis: modified Jones criteria
Two major criteria, or one major and two minor criteria, when there is also evidence of a previous strep infection, support the diagnosis of rheumatic fever

Major criteria
The mnemonic JONES is often used to recall the Major Criteria.
1,Joints (Migratory polyarthritis): a temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards.
2.O [imagine heart-shaped O] (carditis): inflammation of the heart muscle which can manifest as congestive heart failure with shortness of breath, pericarditis with a rub, or a new heart murmur.
3.Nodules (subcutaneous nodules - a form of Aschoff bodies): painless, firm collections of collagen fibers on the back of the wrist, the outside elbow, and the front of the knees. These now occur infrequently.
4.Erythema marginatum: a long lasting rash that begins on the trunk or arms as macules and spreads outward to form a snakelike ring while clearing in the middle. This rash never starts on the face and is made worse with heat.
5.Sydenham's chorea (St. Vitus' dance): a characteristic series of rapid movements without purpose of the face and arms. This can occur very late in the disease.

an additional way to remember the major criteria is by the mnemonic: C.A.N.C.ER
C: Carditis
A: Arthritis
N: Nodules (sub cutaneous)
C: Chorea
ER: ERythema Marginatum

Minor criteria
1.Fever: temperature elevation
2.Arthralgia: Joint pain without swelling
3.Laboratory abnormalities: increased Erythrocyte sedimentation rate, increased C reactive protein, leukocytosis
4.Electrocardiogram abnormalities: a prolonged PR interval

sources?? encik wikiii..



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