2016 ACR/EULAR Revised Criteria for too Early Diagnosis of Rheumatoid Arthritis

Rheumatoid Arthritis (RA) as a chronic progressive systemic autoimmune disease with hallmark of chronic erosive polyarthritis is the most common inflammatory articular disorder. Its overall prevalence is 1% and it is more common in middle to old aged women. Arthritis of peripheral synovial joints can be seen in almost all patients with RA. Chronic symmetric oligo/polyarthritis with especially small joints involvement of hand along with prolonged morning stiffness is the predominant feature of RA. Extra-articular manifestations of RA usually can not be seen within initial presentation of it. High titer RF or Anti-CCP and both RF and Anti-CCP positivity are serologic hallmarks of disease. Erosion is imaging hallmark of RA that can be detected in MRI much earlier than in plain X-Ray of involved joint. Positive family history of RA and HLA-DR4 positivity are associated with higher risk of future RA. Smoking is the most important environmental factor for development of RA. The 1987 ACR criteria and the 2010 ACR/EULAR criteria for RA ;both are designed for classification of RA but the Iran criteria for RA (2011) can be used for early diagnosis of RA with clinical synovitis during the acute to early chronic phase of disease. The corresponding-author of this letter wants to deliver a new criteria called “2016 ACR/EULAR revised criteria for too early diagnosis of RA”in the first week of initiation of RA especially subclinical cases.