Jones Criteria

By | June 5, 2017
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The American Heart Association has decided on certain guidelines to make it easier for doctors to diagnose an autoimmune disease, called rheumatic fever. These guidelines are known as Jones Criteria. They prove quite beneficial in the diagnosis of rheumatic fever, a disease caused by a group of streptococcal bacteria. It causes inflammation in connective tissue especially that of the joints, heart, subcutaneous tissue, and blood vessels. The description of disease first became known in the 1500s, but the association between it and a throat infection was not described until the 1880s – it was associated with fever later in the 1900s.

Rheumatic fever was a leading cause of death before the broad availability of penicillin. It was also among the leading causes of acquired heart disease in adults. It produces several symptoms that can affect different parts of your body, including the joints, heart, brain, and skin. As there is still no diagnostic test available to confirm rheumatic fever, the AMA presented Jones Criteria to assist the doctors in making an accurate diagnosis. Keep reading to learn more about rheumatic fever criteria and the way it helps physicians.

What Are the Jones Criteria?

Jones Criteria of rheumatic fever are basically the combination of one major and two minor plus a history of throat infection. Thephysician needs this information to make the diagnosis of rheumatic fever. The major rheumatic fever criteria include the following:

  • Nodules under the skin (Aschoff bodies or subcutaneous nodules)
  • Heart inflammation
  • Sydenham’s chorea or rapid, jerky movements
  • Skin rash

The minor Jones Criteria include the following:

  • High erythrocyte sedimentation rate, a basic sign of inflammation
  • Fever with joint pain
  • Changes in electrocardiogram
  • Elevated streptococcal antigen test, elevated c-reactive protein, and other lab findings

What Tests Are Needed to Diagnose Rheumatic Fever?

Jones Criteria rheumatic fever helps make a decision, but a physician may also use a physical exam and test results to get to a conclusion.

Physical Exam

Your doctor will conduct a thorough physical exam that will include checking for fever, checking the joints for pain and inflammation, and examining the skin for a rash. This may also include listening to the heart for abnormal murmurs, rhythms, or muffled sounds that usually indicate inflammation. Your doctor may also conduct a number of movement tests to notice any inflammation affecting the central nervous system.

Tests for Strep Infection

If you have already been diagnosed with a strep infection, there is usually no need to take any tests for the bacterium. In case your doctor is not sure, they may order a blood test to detect antibodies circulating in the blood. It is important to mention that the actual bacteria may no longer be present in your throat tissue or even blood.

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Electrocardiogram

Your doctor may order an electrocardiogram that records electrical signals when they travel through your heart. Your physician will actually look for specific patterns among those signals to confirm any inflammation of the heart.

Echocardiography

The procedure involves using sound waves to get live-action images of your heart. The test plays an important role in identifying any altered structured within your heart. It will also help find out more about any damage done to heart valves. You may have to undergo echocardiography again in the future if you have had recovered from rheumatic fever.

What Are the Treatments for Rheumatic Fever?

The treatment options are available to help destroy remaining group of bacterial and relieve symptoms. Certain treatment options will also help control inflammation and prevent further episodes of rheumatic fever. Jones Criteria really help in this regard.

The treatment options may include the following:

  • Antibiotics: You may have to start with penicillin, which is an effective way of eliminating the remaining strep bacteria. After completing the antibiotic treatment, you will have to complete another course of antibiotics to ensure you don’t have to deal with rheumatic fever again. If your child is undergoing this treatment regime, he/she may have to continue with it until he/she is at least 21 years old. An older teenager may have to continue with the treatment up to 20 years old. It is important to complete a 5-year course to prevent recurrence of rheumatic fever.
  • Anti-inflammatory treatment: Your doctor will also prescribe a pain reliever to alleviate pain and reduce inflammation. They may start with naproxen or aspirin. These medications will also help you with fever and pain. If your child’s symptoms aren’t improving after the use of regular pain relievers, your doctor may also consider giving prednisone or another corticosteroid.
  • Anticonvulsant medications: Sometimes, the movements of Sydenham chorea are quite serious. Your doctor will make use of anticonvulsants, such as carbamazepine or valproic acid to treat this condition.

Long-Term Care

If your child has just recovered from rheumatic fever, it is important to work with your doctor and learn everything about the type of follow-up and long-term care your child needs. The problem is that how much damage rheumatic fever has done to the heart may take a few years to show, so follow-up care is important. It is important to let your child know of it and make them understand to convey any physical changes or symptoms they may experience later in life, so you could take some steps to keep things under control.

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