Table 1.

Criteria for inclusion as extraarticular manifestations of rheumatoid arthritis. From: Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years. Turesson C, O’Fallon WM, Crowson CS, Gabriel SE, Matteson EL. Ann Rheum Dis 2003;62:722–7, with permission from BMJ Publishing Group Ltd.13

1. Pericarditis(A) Clinical judgment and exudation verified by echocardiography, if ultrasound not available
(B) Clinical criteria (1 required): Typical pericardial pain, peripheral oedema, dyspnoea/orthopnoea, ascites, dysrythmia (heart rate > 140/min, atrial flutter/fibrillation, 2–3 degrees atrioventricular block, ventricular tachycardia)
Objective criteria compatible with pericarditis (1 required)
Physical examination
Cardiac catheterisation findings
Histological examination
Other causes improbable, such as tuberculosis or other infection, metastases, primary tumour, postoperative status or other trauma
2. PleuritisClinical judgment and exudation verified by x-ray examination
Other causes improbable, such as tuberculosis or other infection, metastases, primary tumour, postoperative status or other trauma
3. Felty’s syndromeSplenomegaly (clinically evident or measured by ultrasound) and neutropenia (< 1.8 × 109/l) on two occasions
Other causes improbable, such as drug side effect or infection
4. Major cutaneous vasculitisDiagnostic biopsy or clinical judgment by dermatologist
5. NeuropathyClinical judgement by doctor and signs of polyneuropathy/mononeuropathy at electromyography/electroneurography
6. Scleritis, episcleritis or retinal vasculitisClinical judgment by ophthalmologist
7. GlomerulonephritisClinical judgment by nephrologist and positive biopsy
8. Vasculitis affecting other organsClinical judgment by organ specialist and biopsy compatible with vasculitis
9. AmyloidosisClinical judgment and positive biopsy from affected organ
10. Keratoconjunctivitis siccaClinical judgment
Positive Rose-Bengal staining or result of Schirmer’s test < 5 mm/min
11. XerostomiaClinical judgment
Abnormal sialometry, sialography, salivary scintigraphy or salivary gland biopsy with lymphocytic infiltrate
12. Secondary Sjögren’s syndromeTwo of three criteria: Keratoconjunctivitis sicca (see above); Xerostomia (see above); Serological evidence: rheumatoid factor, ANA, anti-Ro (SSA), anti-La (SSB) positive, or hypergammaglobulinaemia
13. Pulmonary fibrosisClinical judgment and
Decreased vital capacity or carbon dioxide transfer factor by 15% from normal
14. Bronchiolitis obliterans organising pneumoniaClinical judgment by pulmonologist
15. Cervical myelopathyClinical judgment
Increased atlantoaxial movement — verified by x-ray examination
16. Subcutaneous rheumatoid nodulesClinical judgment
17. Rheumatoid nodules in other locationsPositive biopsy