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    Patent Pending

    ACR/EULAR Gout Classification Criteria

    Provides formal diagnostic criteria for gout.

    INSTRUCTIONS

    The Acute Gout Diagnosis Rule can help rule in or rule out gout, reducing the need for synovial fluid in highly likely patients and encouraging a broad differential in gout-unlikely patients.

    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with mono or oligo-arthritis of unclear etiology where gout is in the differential diagnosis.
    • The ACR/EULAR Classification can be used to formally diagnose gout.
    • The criteria allow for a non-synovium diagnosis of gout (since presence of monosodium urate crystals in a symptomatic joint is the gold standard for gout) to assist clinicians when synovial testing is not possible (small joint, lab testing not available).
    • These criteria can substitute for synovial fluid analysis (the gold standard) if fluid analysis is not possible, or if there are sufficient other criteria that the patient meets.
    Step One - Entry Criterion

    If yes, 7+ Classification Criteria required for positive diagnosis

    Step Two - Sufficient Criterion

    If yes, diagnosis is positive

    Step Three - Classification Criteria

    7+ required for positive diagnosis

    0
    Joint/bursa other than ankle, midfoot or 1st MTP (or involvement in a polyarthritis)
    1
    Ankle OR midfoot (as part of monoarticular/oligoarticular episode without 1st MTP)
    2
    1st MTP (as part of monoarticular or oligoarticular episode)
    0
    No Characteristics
    1
    One Characteristics
    2
    Two Characteristics
    3
    Three Characteristics
    0
    No typical episodes
    1
    One typical episode
    2
    Recurrent typical episodes
    0
    Absent
    4
    Present
    -4
    < 4mg/dL [< 0.24mM]
    0
    ≥ 4 or < 6mg/dL [≥ 0.24 or < 0.36mM]
    2
    ≥ 6 or < 8mg/dL [≥ 0.36 or < 0.48mM]
    3
    ≥ 8 or < 10mg/dL [≥ 0.48 or < 0.60mM]
    4
    ≥ 10mg/dL [≥ 0.60mM]
    -2
    Negative for MSU
    0
    Not done
    0
    Absent or not done
    4
    Present
    0
    Absent
    4
    Present

    Diagnostic Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Tuhina Neogi

    About the Creator

    Tuhina Neogi, MD, PhD, is an associate professor at Boston University School of Medicine. She is also affiliated with the BUSPH Department of Epidemiology. Dr. Neogi’s research focuses on epidemiology and management of various musculoskeletal/rheumatic diseases, such as osteoarthritis and gout.

    To view Dr. Tuhina Neogi's publications, visit PubMed

    Are you Dr. Tuhina Neogi? 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. Tuhina Neogi
    Are you Dr. Tuhina Neogi?