Formerly known as the American Rheumatism Association, ACR, The 1987 American College of Rheumatology was criticized for the lack of sensitivity in the initial phase of the disease. This work is an initiative to establish a revised classification for Rheumatoid Arthritis.

A total of three phases were developed by the joint working group including the ACR and European League against Rheumatism to classify the new approach of RA. These three stages included the identification of inflammatory synovitis among the patients, the factors contributing to the high risk of erosive disease, and the patients who had no risk of being affected. This paradigm was intended at establishing the signs of “rheumatoid arthritis”.


The confirmed presence of synovitis in 1 of the joints was the basis of classifying “definite RA” in the new criteria with the absence pf an alternative diagnosis. Besides, the overall score of 6 or more along with other scores in 4 domains has resulted. The abnormality of the total number of joints and increase in the acute-phase response with the symptom duration was observed in the different stages.

The existing paradigm of RA elaborates the new classification system further identifying the different initial stages of the disease. In the entire study, the persistence of erosive disease and consequent stages of RA was defined while focusing on the need for early diagnosis. In the final stages, controlling and reduction of the occurrence of underlying signs leading to the development of the disease were examined to construct “rheumatoid arthritis.”