The Jones criteria for the diagnosis of Acute Rheumatic Fever (ARF) divide the clinical features into major and minor manifestations, based on their prevalence and specificity. The diagnosis of rheumatic fever requires evidence of a preceding group A streptococcal infection and the case classification is then based on the presence of major and minor manifestations.

Major manifestations:

• carditis
• polyarthritis or aseptic monoarthritis (as defined in the NHF Guidelines)
• erythema marginatum
• chorea (can stand alone for ARF diagnosis)
• subcutaneous nodules.

Minor manifestations:

• polyarthralgia
• fever
• elevated acute phase reactants: erythrocyte sedimentation rate (ESR) or C reactive protein (CRP)
• prolonged PR interval.

Notes:

• if carditis is present as a major manifestation, a prolonged PR interval cannot be considered an additional minor manifestation;
• if polyarthritis or monoarthritis is present as a major manifestation, polyarthralgia cannot be considered an additional minor manifestation.