Severity grading of rheumatoid arthritis

       The functional status of patients with rheumatoid arthritis is generally judged based on a combination of factors such as the patient’s ability to take care of himself/herself including dressing, bathing, eating, makeup and toileting, hobbies including recreation and leisure, and occupational activities such as study, work and household activities. The American College of Rheumatology’s classification criteria for joint function are now commonly used to determine the severity of joint lesions.  Grade I: The joints can move freely and can perform their usual tasks without hindrance.  Grade II: Moderate restriction of joint movement, pain and discomfort in one or more joints, but able to manage daily life.  Grade III: Significant restriction of joint movement, unable to perform work, and difficulty in managing daily life.  Grade Ⅳ: Most or complete loss of mobility, the patient is bedridden or wheelchair dependent for a long time and cannot take care of himself/herself.  It is estimated that 15% of the patients are in Grade I, 40% in Grade II, 30% in Grade III, and 15% in Grade IV joint function. The task of today’s rheumatologists is to enable more patients with rheumatoid arthritis to maintain long-term grade I and II function and reduce the incidence of disability. Patients with rheumatoid arthritis must receive treatment as early as possible.