Calculators & Tools

Jones Criteria (Acute Rheumatic Fever)

Revised 2015 Jones criteria - MODERATE/HIGH-risk population thresholds (applicable to India).

1 What is the Jones Criteria (Acute Rheumatic Fever)?

The Jones Criteria (Acute Rheumatic Fever) is a cardiac scoring tool used in paediatric practice. Revised 2015 Jones criteria - MODERATE/HIGH-risk population thresholds (applicable to India). It scores 9 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in cardiac
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 9 criteria: MAJOR - Carditis (clinical and/or subclinical on echo); MAJOR - Arthritis: mono- or polyarthritis, or polyarthralgia; MAJOR - Chorea; MAJOR - Erythema marginatum; MAJOR - Subcutaneous nodules; MINOR - Monoarthralgia; MINOR - Fever ≥ 38 °C; MINOR - ESR ≥ 30 mm/h and/or CRP ≥ 3 mg/dL; MINOR - Prolonged PR interval for age. Totals are then banded: any score - Criteria not met: does not meet the revised Jones criteria. Note that ALL diagnoses additionally require evidence of preceding group A streptococcal infection (ASO/anti-DNase B rise, positive throat culture or RADT); 5 weighted points or more - Criteria met: meets Jones criteria (2 major, OR 1 major + 2 minor) - with evidence of preceding GAS infection this supports acute rheumatic fever. Start penicillin, anti-inflammatory therapy and echocardiography; plan secondary prophylaxis; 6 weighted points or more - Criteria met - multiple major: two or more major manifestations - acute rheumatic fever highly likely with evidence of preceding GAS infection. Echocardiography is mandatory; arrange cardiology review and secondary prophylaxis.
  • India is a MODERATE/HIGH-risk population, so these relaxed thresholds apply: monoarthritis and polyarthralgia count as major; monoarthralgia, fever ≥38 °C and ESR ≥30 count as minor.
  • Diagnosis requires 2 major, or 1 major + 2 minor, PLUS evidence of preceding group A streptococcal infection.
  • Source: Gewitz MH et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography. AHA Scientific Statement. Circulation 2015;131:1806-18.

4 Frequently asked questions

How many criteria does the Jones Criteria (Acute Rheumatic Fever) use?

9. They are MAJOR - Carditis (clinical and/or subclinical on echo); MAJOR - Arthritis: mono- or polyarthritis, or polyarthralgia; MAJOR - Chorea; MAJOR - Erythema marginatum; MAJOR - Subcutaneous nodules; MINOR - Monoarthralgia; and others.

What do the bands of the Jones Criteria (Acute Rheumatic Fever) mean?

The total is interpreted as: any score - Criteria not met: does not meet the revised Jones criteria. Note that ALL diagnoses additionally require evidence of preceding group A streptococcal infection (ASO/anti-DNase B rise, positive throat culture or RADT); 5 weighted points or more - Criteria met: meets Jones criteria (2 major, OR 1 major + 2 minor) - with evidence of preceding GAS infection this supports acute rheumatic fever. Start penicillin, anti-inflammatory therapy and echocardiography; plan secondary prophylaxis; 6 weighted points or more - Criteria met - multiple major: two or more major manifestations - acute rheumatic fever highly likely with evidence of preceding GAS infection. Echocardiography is mandatory; arrange cardiology review and secondary prophylaxis.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

India is a MODERATE/HIGH-risk population, so these relaxed thresholds apply: monoarthritis and polyarthralgia count as major; monoarthralgia, fever ≥38 °C and ESR ≥30 count as minor.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.