Rheumatic fever: Ducket-Jones diagnostic criteria

There must be evidence of streptococcal infection plus:

2 major or 1 major + 2 minor

Major criteria


  • Carditis – tachycardia, murmurs (mitral/aortic regurgitation), pericardial rub
  • Arthritis – migratory flitting polyarthritis, usually larger joints
  • Subcutaneous nodules – small, painless, mobile nodules on extensor surfaces
  • Erythema marginatum
  • Sydenham’s chorea

Minor criteria


  • Fever
  • Raised CRP/ESR
  • Arthralgia (unless arthritis is included in major criteria)
  • Prolonged PR interval (unless carditis included in major criteria)
  • Previous rheumatic fever

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