Rheumatic fever occurs after a streptococcal infection (usually caused by Group A Beta-Hemolytic Strep (GABHS)). It is an inflammatory condition that affects the joints, skin, heart and brain. Major criteria are referred to as Jones criteria and can be remembered by the mnemonic of the same name.
- J – Joint involvement which is usually migratory and inflammatory joint involvement that starts in the lower joints and ascends to upper joints
- O – (“O” Looks like heart shape) – indicating that patients can develop myocarditis or inflammation of the heart
- N – Nodules that are subcutaneous
- E – Erythema marginatum which is a rash of ring-like lesions that can start in the trunk or arms. When joined with other rings, it can create a snake-like appearance
- S – Sydenham chorea is a late feature which is characterized by jerky, uncontrollable, and purposeless movements resembling twitches
Minor criteria include
- C – CRP Increased
- A – Arthralgia
- F – Fever
- E – Elevated ESR
- P – Prolonged PR Interval
- A – Anamesis
- L – Leukocytosis
Diagnosis of rheumatic fever is made after a strep infection (indicated by either throat cultures growing GABHS OR elevated anti-streptolysin O titers in the blood) and:
- Two major criteria OR
- One major criterion and two minor criteria
Mnemonics by themselves are not the answer to remembering everything. However, if you know the basics and underlying issues, then a mnemonic can serve to help you recall the exam details that can easily get lost.
This is the first in our series of Medical Mnemonics Monday posts. You can see all futuremedical mnemonics here.
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