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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Acute Gout Diagnosis Rule

    Risk stratifies for gout vs non-gout arthritis and helps determine which patients benefit most from joint aspiration.
    When to Use
    Pearls/Pitfalls
    Why Use

    A patient with a new monoarthritis.

    • The Acute Gout Diagnosis Rule helps reduce unnecessary joint aspirations by predicting gout risk based on clinical criteria.
    • It was originally studied and validated in two primary care cohorts in Europe, so may not be as applicable in non-European populations.
    • Score correlates with likelihood of gout, with scores ≤4 unlikely to be gout, scores ≥8 likely to be gout, and 4-8 indeterminate.
    • False positives in the studies were mostly “unknown arthritis” and management typically did not change. Septic arthritis was not seen in these high scores.
    • Low scores are unlikely to be gout and other causes of gout should be considered, including pseudogout, septic arthritis, reactive arthritis, psoriatic, rheumatoid, or osteoarthritis.
    • The Acute Gout Diagnosis Rule can help rule in or rule out the diagnosis of gout, and help determine which patients benefit from joint aspiration and which could be treated empirically for gout specifically.
    • The rule also out-performs clinician gestalt and improves diagnostic accuracy.
    No
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    Yes
    +2
    No
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    +2
    No
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    Yes
    +0.5
    No
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    +1
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    Yes
    +2.5
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    +1.5
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    +3.5

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Hein Janssens

    About the Creator

    Hein J. E. M. Janssens, MD, is a researcher in the Department of Primary and Community Care, Radboud University Nijmegen Medical Center, in Nijmegen, the Netherlands. He practices in the fields of internal medicine, primary care and rheumatology.

    To view Dr. Hein Janssens's publications, visit PubMed

    Are you Dr. Hein Janssens? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Hein Janssens
    Are you Dr. Hein Janssens?