Calculators · Rheumatology · Score

DAS28-ESR (Disease Activity Score, 28 joints)

Also called DAS28, disease activity score ESR, RA disease activity

Rheumatoid arthritis disease activity from 28-joint counts, ESR and patient global health, with EULAR activity bands.

mm/h
mm (0–100)

Leave blank to use the validated 3-variable formula.

Fill 3 more fields to see the result.

Formula and scoring

DAS28(4) = 0.56·√TJC28 + 0.28·√SJC28 + 0.70·ln(ESR) + 0.014·GH (GH on 0–100 mm VAS). DAS28(3) = [0.56·√TJC28 + 0.28·√SJC28 + 0.70·ln(ESR)] × 1.08 + 0.16.

Exam and ward pearls

  • The 28 joints: shoulders, elbows, wrists, MCPs 1–5, PIPs 1–5 (both sides) and knees — feet and ankles are not counted.
  • Tender joints carry twice the weight of swollen joints, so pain-driven (e.g. coexisting fibromyalgia) scores can look "active".

When not to rely on it

  • DAS28 remission (<2.6) can coexist with several swollen joints; ACR/EULAR Boolean or SDAI ≤3.3 is the stricter remission definition.
  • ESR rises with age, anaemia and female sex; prefer DAS28-CRP or CDAI when ESR is unreliable.

Source

  1. Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38(1):44-8. doi:10.1002/art.1780380107 · PMID 7818570
  2. Radboud university medical center. DAS28: how to calculate the DAS28 and alternative validated formulae (das-score.nl). Link
  3. England BR, Tiong BK, Bergman MJ, et al. 2019 Update of the American College of Rheumatology recommended rheumatoid arthritis disease activity measures. Arthritis Care Res (Hoboken). 2019;71(12):1540-55. doi:10.1002/acr.24042 · PMID 31709779

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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