major Jones criteria
Last reviewed 01/2018
These are:
- carditis:
- endocarditis, myocarditis, and/or pericarditis
- changing murmurs, pericardial rub, cardiomegaly, conduction defects
- cardiac involvement occurs in 45 to 70%
- the confirmation of subclinical rheumatic carditis via echocardiographic findings is controversial - see note 1
- migratory polyarthritis - red and tender joints in 75% of patients
- Sydenham's chorea (St Vitus dance), commoner in females, in 10% of patients
- subcutaneous nodules in 2 to 20%
- erythema marginatum in 2 to 10%, involving the arms, thighs and trunk
Note 1: it has been stated that there seems to be adequate experience that when strict criteria for echocardiographic diagnosis are adhered to, the finding of aortic or mitral regurgitation, even though inaudible, should be accepted as a major criterion in those with chorea or isolated polyarthritis (1).
Reference:
- (1) Lancet (2001). Commentary - time to take soundings in acute rheumatic fever, 357 (9273), 1994-5.