Table 1.

Gout diagnosis. Items included in the ACR proposal (ACRp)6 and EULAR recommendations (EULARr)7.

ACRpEULARr
MSU crystals in joint fluid or tophi; OR ≥ 6MSU crystal confirmed in joint fluid or tophi
1. > 1 attack of acute arthritis
2. Maximum inflammation developed within 1 day1. Rapid pain and swelling, reaching a maximum in 6–12 h (LR 1.27)
3. Monoarthritis/oligoarthritis attack*
4. Redness observed over joints2. Erythema (LR 2.44)
5. 1st MTP joint painful or swollen3. Podagra (LR 30.64)
6. Unilateral 1st MTP joint attack
7. Unilateral tarsal joint attack
8. Tophi (proven or suspected)4. Definite and possible tophi (LR 39.95 and 33.99)
9. Hyperuricemia5. Hyperuricemia (LR 7.61)
10. Asymmetric swelling within a joint on radiograph6. Radiographic asymmetric swelling (LR 4.13)
11. Subcortical cysts without erosions on radiograph7. Radiographic subcortical cysts, no erosions (LR 6.39)
12. Joint fluid culture-negative*
  • * Proposed criteria for acute arthritis of primary gout considers monoarthritis (item 3) and item 12. Proposed survey criteria for acute arthritis of primary gout consider oligoarthritis (item 3), and “Complete termination of an attack” instead of 12. LR: Likelihood ratios reported in the text.