What joints are counted in the DAS28?

The 28 joints assessed are: both shoulders (2), both elbows (2), both wrists (2), 10 metacarpophalangeal joints (MCP 1–5 bilateral), 10 interphalangeal joints (8 PIP 2–5 bilateral and 2 thumb IP bilateral), and both knees (2). Hips, ankles, and feet are not included in the DAS28 assessment.

What is the DAS28 cut-off for remission?

The conventional DAS28 bands are remission below 2.6, low activity from 2.6 through 3.2, moderate activity above 3.2 through 5.1, and high activity above 5.1. DAS28-ESR and DAS28-CRP can differ for the same patient, so record the variant and avoid treating them as interchangeable longitudinal measurements.

If DAS28-ESR is 3.2, what category is it in?

A DAS28 of exactly 3.2 is low disease activity, because the low band runs from 2.6 through 3.2. Moderate activity starts above 3.2, so 3.21 would be moderate.

What is the difference between DAS28-ESR and DAS28-CRP?

DAS28-ESR uses ESR in mm/hr: 0.56×√TJC + 0.28×√SJC + 0.70×ln(ESR) + 0.014×PGA. DAS28-CRP uses CRP in mg/L: 0.56×√TJC + 0.28×√SJC + 0.36×ln(CRP+1) + 0.014×PGA + 0.96. This tool converts mg/dL to mg/L when that CRP unit is selected.

Does DAS28-ESR use the 1-hour or 2-hour ESR?

The 1-hour value. DAS28-ESR takes ESR in mm/hr, which is the standard first-hour (Westergren) reading; a 2-hour ESR is not part of the formula.

How is patient global health (PGA) scored in DAS28?

The Patient Global Assessment (PGA) is recorded on a 0–100 mm visual analog scale (VAS). The patient marks a point on a 100 mm line where 0 = no disease activity at all and 100 = maximum possible disease activity. The value enters the formula as 0.014 × PGA, so a rating of 50 adds 0.70 points.

Can DAS28 be used for conditions other than RA?

DAS28 was developed and validated specifically for rheumatoid arthritis. It is sometimes used off-label for psoriatic arthritis and other inflammatory arthritides, but it is not the preferred tool for those conditions. ACR and EULAR recommend DAS28 primarily for RA assessment.

Is this calculator a substitute for clinical judgment?

No. DAS28 is a clinical decision-support tool. Scores should always be interpreted in the context of a full clinical assessment, imaging findings, functional status, and individual patient factors. Treatment decisions should be made by a qualified rheumatologist.

DAS28 Rheumatoid Arthritis Score

Calculate DAS28-ESR or DAS28-CRP to assess rheumatoid arthritis disease activity and determine remission, low, moderate, or high activity status.

A DAS28 calculator scores rheumatoid arthritis activity from 28-joint tender and swollen counts, ESR or CRP, and a 0–100 patient global rating: DAS28-ESR = 0.56×√TJC + 0.28×√SJC + 0.70×ln(ESR) + 0.014×PGA.

DAS28 Inputs

Inflammatory Marker

Tender Joint Count (TJC28) 0 – 28

Swollen Joint Count (SJC28) 0 – 28

ESR (mm/hr)

Patient Global Assessment (PGA) 0 – 100 mm VAS

0 = no activity, 100 = maximum activity

Enter values on the left and click Calculate DAS28 to see the score.

DAS28 Score

ESR

—

EULAR disease activity

0 2.6 3.2 5.1 9.4

Clinical Interpretation

Formula Breakdown

√TJC28

√SJC28

ln(ESR)

PGA term

EULAR Activity Thresholds

Category	DAS28 Range	Meaning
Remission	< 2.6	Conventional remission band
Low Activity	2.6 – 3.2	Conventional low-activity band
Moderate Activity	3.2 – 5.1	Conventional moderate-activity band
High Activity	> 5.1	Conventional high-activity band

Formula and interpretation sources

Quick answer

Example: TJC 8, SJC 5, ESR 35 mm/hr, PGA 50: 1.58 + 0.63 + 2.49 + 0.70 = DAS28-ESR 5.40, high disease activity

Switch between DAS28-ESR and DAS28-CRP and see every formula term worked out.

Summary

The DAS28 (Disease Activity Score in 28 joints) is a composite measure used to describe rheumatoid arthritis disease activity. This calculator implements the validated four-variable ESR and CRP formulas using tender and swollen 28-joint counts, an inflammatory marker, and a 0–100 mm patient global assessment. A score is one part of a clinician’s longitudinal assessment and is not a stand-alone treatment instruction.

How it works

Select the variant: DAS28-ESR (uses erythrocyte sedimentation rate) or DAS28-CRP (uses C-reactive protein).
Enter the 28 Tender Joint Count (TJC28) — the number of joints that are painful on pressure or passive movement.
Enter the 28 Swollen Joint Count (SJC28) — the number of joints with soft-tissue swelling.
Enter the ESR (mm/hr) or CRP (mg/L) laboratory value for the inflammatory marker.
Enter the Patient Global Assessment (PGA) on a 0–100 mm visual analog scale (0 = no activity, 100 = maximum activity).
Click Calculate to see the DAS28 score and EULAR disease activity category.

Use cases

Monitor disease activity at each clinic visit for patients with rheumatoid arthritis.
Record whether a calculated score falls below the conventional DAS28 remission threshold.
Assess response to biologic or DMARD therapy using EULAR response criteria.
Document disease burden for insurance authorization of biologic agents.
Compare pre- and post-treatment scores to quantify therapeutic benefit.
Support clinical trial enrollment and outcome reporting.
Educate patients on their current disease activity level in a standardized way.
Differentiate conventional low, moderate, and high activity bands for discussion with a clinician.

Frequently Asked Questions

Last updated: 2026-09-15 · Reviewed by Nham Vu