Major Jones’ Criteria: JONES
- J – Joint involvement (polyarthritis) which is usually migratory and inflammatory joint involvement that starts in the lower joints and ascends to upper joints
- O – Offended Heart –i.e. myocarditis or inflammation of the heart – new murmur.
- N – Nodules under the skin (subcutaneous nodules)
- E – Erythema 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
- S – Sydenham 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.