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Cardiology Infectious & Inflammatory Heart Disease Intermediate
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Acute Rheumatic Fever: Jones Criteria

JONES
CRITERIA
Major criteria for diagnosing Acute Rheumatic Fever following Group A Streptococcus (GAS) pharyngitis.

Rheumatic fever represents a post-streptococcal autoimmune cross-reaction (molecular mimicry) between streptococcal M protein and host human cardiac/myosin tissues.

Systematic Breakdown

J

Joints (Migratory Polyarthritis)

Migratory swelling and severe pain primarily affecting large joints (knees, ankles, wrists, elbows); exquisitely responsive to aspirin.

O

O (Heart / Carditis)

Pancarditis (endocarditis, myocarditis, pericarditis). Mitral valve is most frequently damaged, followed by aortic valve.

N

Nodules (Subcutaneous)

Firm, painless, small nodules over bony prominences or extensor surfaces (elbows, knuckles).

E

Erythema Marginatum

Non-pruritic, annular, erythematous rash with snake-like advancing edges and central clearing on trunk and limbs (spares face).

S

Sydenham Chorea

Involuntary, rapid, non-repetitive choreiform movements of face and limbs ('St. Vitus dance'), often a late manifestation.

High-Yield Clinical Pearls & Exam Tips
  • Diagnosis requires evidence of preceding GAS infection (elevated ASO or anti-DNase B titers) PLUS either 2 Major criteria OR 1 Major + 2 Minor criteria.
  • Minor criteria: Arthralgia, Fever, elevated ESR/CRP, prolonged PR interval on ECG.
  • Penicillin prophylaxis is required long-term to prevent recurrent rheumatic attacks and chronic valvular stenosis.
Related Pharmaceuticals
Penicillin G Aspirin Prednisone
Related Clinical Conditions
Mitral Stenosis Streptococcal Pharyngitis Infective Endocarditis
Authoritative Sources: Circulation - AHA Guidelines on Jones Criteria · First Aid for the USMLE Step 1

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