What Is The American College Of Rheumatology (ACR) Scoring System For Rheumatoid Arthritis And How Does It Work?

— -- Question: What is the American College of Rheumatology (ACR) scoring system for rheumatoid arthritis and how does it work?

Answer: Well, the scoring system was promulgated because researchers needed to know exactly what was an improvement in the disease when they were treating patients with various medications. And so they came up with, initially, the ACR 20, which is a 20 percent improvement based on a certain scale. And this scale would include a number of tender and painful joints -- usually it goes as 28 designated joints. At this time it's the best scale.

And then there's a number of other factors that are looked at: a laboratory test, either the sedimentation rate or C-reactive protein, which are markers of inflammation. There's a scale that's done with a physician's assessment of the patient's progress, the patient's assessment of the patient's progress, a pain scale, and a disability scale. And three of the five are usually used in any study, along with the tender and painful joint count. And then there's designated as either an ACR 20, which is a 20 percent improvement, or, more frequently now, an ACR 50 or ACR 70, which are much more dramatic improvements of 50 or 70 percent in the function.

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