Jones基準(急性リウマチ熱2015)
用途適応: suspected ARF when major/minor manifestations and GAS evidence are being assessed.
層別Classification aid for initial ARF. Echo carditis counts as major in 2015 revision.
限界非適応: as a substitute for full rheumatology/cardiology work-up. · 落とし穴: applying low-risk cutoffs in endemic high-prevalence regions. · Post-strep reactive arthritis and other mimics exist.
出典Gewitz MH, et al. Circulation 2015 (Jones criteria)
当直の次の一手
スコア後:シーン連算・隣接スコア・対応パスへ。ローカル参照のみ、HIS書き込みなし。
方法論 · 代入例・ガイドライン要点・詳細
適用場面
適応: suspected ARF when major/minor manifestations and GAS evidence are being assessed.
入力項目
- ARF prevalence setting · 選択
- Evidence of preceding group A strep (culture / rapid Ag / rising ASO-antiDNaseB) · 選択
- Major: Carditis (clinical and/or subclinical echo) · 選択
- Major: Arthritis (poly in low-risk; mono/poly/polyarthralgia allowable in mod/high) · 選択
- Major: Sydenham chorea · 選択
- Major: Erythema marginatum · 選択
- Major: Subcutaneous nodules · 選択
- Minor: Fever (≥38.5 °C low-risk / ≥38.0 °C mod-high) · 選択
- Minor: Arthralgia (poly low-risk; mono mod-high) — only if arthritis major absent · 選択
- Minor: Elevated ESR/CRP (ESR≥60 low-risk or ≥30 mod-high; and/or CRP≥3.0 mg/dL) · 選択
- Minor: Prolonged PR (after accounting for age; only if carditis major absent) · 選択
計算方法と公式
Low-risk: 2 major or 1 major+2 minor. Mod/high-risk: also allows 3 minor. Plus preceding GAS (exceptions: chorea / indolent carditis).
Select prevalence setting; count majors/minors with exclusion rules (arthralgia if no arthritis major; PR if no carditis major).
計算例(数値代入)
以下の数値は本ツールの入力欄に定義された例示値であり、本ページの数式でサーバー側で実際に計算したものです。計算過程を素早く確認できます。代入方法の例示のみで、臨床上の助言ではなく、実在する症例でもありません。
| ARF prevalence setting | Low-risk population |
|---|---|
| Evidence of preceding group A strep (culture / rapid Ag / rising ASO-antiDNaseB) | No / pending |
| Major: Carditis (clinical and/or subclinical echo) | No |
| Major: Arthritis (poly in low-risk; mono/poly/polyarthralgia allowable in mod/high) | No |
| Major: Sydenham chorea | No |
| Major: Erythema marginatum | No |
| Major: Subcutaneous nodules | No |
| Minor: Fever (≥38.5 °C low-risk / ≥38.0 °C mod-high) | No |
| Minor: Arthralgia (poly low-risk; mono mod-high) — only if arthritis major absent | No / N/A |
| Minor: Elevated ESR/CRP (ESR≥60 low-risk or ≥30 mod-high; and/or CRP≥3.0 mg/dL) | No |
| Minor: Prolonged PR (after accounting for age; only if carditis major absent) | No / N/A |
→Jones 2015Criteria not met
- Majors / minors:0 / 0
- Pathway:—
- Setting:Low-risk
| ARF prevalence setting | Moderate / high-risk population |
|---|---|
| Evidence of preceding group A strep (culture / rapid Ag / rising ASO-antiDNaseB) | Yes |
| Major: Carditis (clinical and/or subclinical echo) | Yes |
| Major: Arthritis (poly in low-risk; mono/poly/polyarthralgia allowable in mod/high) | Yes |
| Major: Sydenham chorea | Yes |
| Major: Erythema marginatum | Yes |
| Major: Subcutaneous nodules | Yes |
| Minor: Fever (≥38.5 °C low-risk / ≥38.0 °C mod-high) | Yes |
| Minor: Arthralgia (poly low-risk; mono mod-high) — only if arthritis major absent | Yes |
| Minor: Elevated ESR/CRP (ESR≥60 low-risk or ≥30 mod-high; and/or CRP≥3.0 mg/dL) | Yes |
| Minor: Prolonged PR (after accounting for age; only if carditis major absent) | Yes |
→Jones 2015Criteria met (with strep evidence)
- Majors / minors:5 / 2
- Pathway:≥2 major
- Setting:Mod/high-risk
結果の判読と層別
Classification aid for initial ARF. Echo carditis counts as major in 2015 revision.
ガイドライン要点(独自整理)
- 2015 AHA revision.
- GAS evidence usually required.
- 次: echo / secondary prophylaxis.
以上は該当ガイドラインの要点を本サイトが独自に整理したものであり、原文の引用ではありません。
注意点と限界
- 非適応: as a substitute for full rheumatology/cardiology work-up.
- 落とし穴: applying low-risk cutoffs in endemic high-prevalence regions.
- Post-strep reactive arthritis and other mimics exist.
照合と出典 · 検証可能なガバナンス
参考ガイドラインと出典
- Gewitz MH, et al. Circulation 2015 (Jones criteria) · 出典 ↗
ガイドライン全文の著作権は各学会・出版社に帰属します。 · データセット整理日 2026-10-08
よくある質問
よくある質問
- Jones基準(急性リウマチ熱2015)は患者データをアップロードしますか?どこで計算しますか?
- 計算はブラウザ内でローカルに行われ、入力と結果はサーバーに送信されません。免許を有する医師向けであり、病歴・検査・施設プロトコルと合わせて解釈すること。診断や処方の代替ではありません。
- Jones基準(急性リウマチ熱2015)は実際にどう計算しますか?計算例を示せますか?
- 代入値: ARF prevalence setting Low-risk population、Evidence of preceding group A strep (culture / rapid Ag / rising ASO-antiDNaseB) No / pending、Major: Carditis (clinical and/or subclinical echo) No、Major: Arthritis (poly in low-risk; mono/poly/polyarthralgia allowable in mod/high) No、Major: Sydenham chorea No、Major: Erythema marginatum No、Major: Subcutaneous nodules No、Minor: Fever (≥38.5 °C low-risk / ≥38.0 °C mod-high) No… → 結果: Jones 2015 Criteria not met(Majors / minors: 0 / 0、Pathway: —、Setting: Low-risk) 代入値: ARF prevalence setting Moderate / high-risk population、Evidence of preceding group A strep (culture / rapid Ag / rising ASO-antiDNaseB) Yes、Major: Carditis (clinical and/or subclinical echo) Yes、Major: Arthritis (poly in low-risk; mono/poly/polyarthralgia allowable in mod/high) Yes、Major: Sydenham chorea Yes、Major: Erythema marginatum Yes、Major: Subcutaneous nodules Yes、Minor: Fever (≥38.5 °C low-risk / ≥38.0 °C mod-high) Yes… → 結果: Jones 2015 Criteria met (with strep evidence)(Majors / minors: 5 / 2、Pathway: ≥2 major、Setting: Mod/high-risk)
照合手順
照合と根拠
本ツールの数式と計算方法は本ページに明示しており、公開のうえ逐一照合できます。数式・係数・閾値は上記の権威ある情報源に基づき照合しています。 臨床ツール一覧 →