Jones criteria

The Jones criteria can be used to establish the diagnosis of rheumatic fever. They were first published in 1944 by T. Duckett Jones, MD and have been periodically revised by the American Heart Association in collaboration with other groups.^[1][2]

The Jones Criteria for definitive rheumatic fever require evidence of streptococcal infection: elevated or rising antistreptolysin O titre or DNAase and either:

• Two major criteria

OR

• One major and two minor criteria

Exceptions are chorea and indolent carditis, each of which by itself can indicate rheumatic fever.^{[3][4][5][1][2]}

• Firm alternate diagnosis to rheumatic fever
• Does not meet criteria below

• Polyarthritis: a temporary migrating inflammation of the large joints, usually starting in the legs and migrating upwards
• 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
• Subcutaneous nodules: painless, firm collections of collagen fibers over bones or tendons, commonly presenting on the back of the wrist, the outside elbow, and the front of the knees
• Erythema marginatum: a long lasting rash that begins on the trunk or arms as macules and spreads outward to form a snake like ring while clearing in the middle, made worse with heat
• Sydenham’s chorea (St. Vitus’ dance): a characteristic series of rapid movements without purpose of the face and arms, occurring late in the disease for at least three months from the onset

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• Fever of 100-102°F (38.2-38.9°C)
• Arthralgia: Joint pain without swelling (Cannot be included if polyarthritis is present as a major symptom)
• Raised erythrocyte sedimentation rate or C reactive protein
• Leukocytosis
• ECG showing features of heart block, such as a prolonged PR interval^[6] (Cannot be included if carditis is present as a major symptom)
• First degree AV block^[7]
• Previous episode of rheumatic fever or inactive heart disease