The criteria for Still's disease, also known as systemic-onset juvenile idiopathic arthritis (SOJIA), were first published in 1971 by Dr. David Cush. These criteria are used to diagnose and differentiate Still's disease from other forms of arthritis, and are known as the Cush criteria.
The Cush criteria include the presence of fever, arthritis or arthralgia, and two or more of the following characteristics:
1. Elevated sedimentation rate (ESR): This is a test that measures the rate of red blood cells settling in a tube of blood. An ESR rate greater than 20 mm/h is indicative of Still's disease.
2. Leukocytosis: This is an increase in white blood cell count, usually above 10,000/mm3.
3. Splenomegaly: This is an enlargement of the spleen due to increased blood flow or abnormal cell growth.
4. Lymphadenopathy: This is an enlargement of the lymph nodes due to infection or inflammation.
5. Rash: This is a skin rash that can be either transient or persistent. It is usually salmon-pink in color and is known as a "slapped cheek" rash.
6. Serum ferritin: This is a test that measures the amount of iron in the blood. An elevated level of ferritin is indicative of Still's disease.
7. Uveitis: This is inflammation of the middle layer of the eye, which can cause redness, pain, and blurred vision.
It is important to note that not all patients with Still's disease will have all of these symptoms, and some may only have one or two. Therefore, it is important for healthcare providers to take a detailed medical history and perform a physical examination in order to determine if a patient meets the criteria for Still's disease.