The Jones criteria diagnose rheumatic fever when there are two major manifestations or one major and two minor.

The Jones criteria diagnose rheumatic fever when there are two major manifestations or one major and two minor.

• A. Two major or one major and two minor
• B. Three major
• C. Two minor
• D. One major and one minor

Answer: (D)

Diagnosis with the Jones criteria hinges on how many major and minor manifestations are present, plus evidence of a prior group A Streptococcus infection. The major manifestations are migratory polyarthritis, carditis, subcutaneous nodules, erythema marginatum, and Sydenham chorea. The minor criteria are fever, arthralgia, elevated acute phase reactants (ESR/CRP), and a prolonged PR interval on ECG. To make the diagnosis, you need either two major manifestations, or one major manifestation plus two minor manifestations, in the setting of recent GAS infection (positive throat culture or rapid antigen test, or an elevated/rising ASO titer). This combination helps ensure specificity, since isolated fever or arthralgia can occur with many illnesses, whereas the documented pattern of major and minor criteria plus infection history points more specifically to rheumatic fever. So a single major with a single minor does not meet the diagnostic threshold, and two minor features alone are not sufficient.

Diagnosis with the Jones criteria hinges on how many major and minor manifestations are present, plus evidence of a prior group A Streptococcus infection. The major manifestations are migratory polyarthritis, carditis, subcutaneous nodules, erythema marginatum, and Sydenham chorea. The minor criteria are fever, arthralgia, elevated acute phase reactants (ESR/CRP), and a prolonged PR interval on ECG. To make the diagnosis, you need either two major manifestations, or one major manifestation plus two minor manifestations, in the setting of recent GAS infection (positive throat culture or rapid antigen test, or an elevated/rising ASO titer). This combination helps ensure specificity, since isolated fever or arthralgia can occur with many illnesses, whereas the documented pattern of major and minor criteria plus infection history points more specifically to rheumatic fever. So a single major with a single minor does not meet the diagnostic threshold, and two minor features alone are not sufficient.