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Tel HaShomer Criteria for the Diagnosis of Familial Mediterranean Fever*

Major Criteria

Typical attacks† of

  • Peritonitis (generalized)

  • Pleuritis (unilateral) or pericarditis

  • Monoarticular arthritis of the hip, knee, or ankle

  • Fever only

Incomplete attacks‡ of the abdomen

Minor Criteria

Incomplete attacks‡ involving the chest, joints, or both

Leg pain with exertion

Favorable response to treatment with colchicineFavorable response to treatment with colchicine

* Diagnosis requires ≥ 1 major criterion or ≥ 2 minor criteria.

† Typical attacks are recurrent (at least 3 episodes of the same type), febrile (rectal temperature ≥ 38° C), and short in duration (12 to 72 hours).

‡ Incomplete attacks are painful and recurrent. They differ from typical attacks in 1 or 2 features:

  • Temperature is normal or < 38° C.

  • Attack lasts longer or shorter than a typical attack but is not less than 6 hours long and lasts no more than 1 week.

  • There are no signs of peritonitis during abdominal attacks.

  • Abdominal attacks are localized.

  • Arthritis occurs in a joint other than the hip, knee, or ankle.

Data from Livneh A, Langevitz P, Zemer D, et al: Criteria for the diagnosis of familial Mediterranean fever. Arthritis Rheum 40(10):1879–1885, 1997. doi: 10.1002/art.1780401023

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