Table 1.

Criteria used for gout diagnosis: 1977 ARA preliminary criteria, Rome criteria, and New York criteria.

The 1977 ARA Preliminary Criteria11Rome Criteria12New York Criteria13
Presence of characteristic urate crystals in the joint fluid*
Presence of a tophus proven to contain urate crystals by chemical means or polarized light microscopy*
Presence of 6 of the following clinical, laboratory, and radiographic phenomena:

  1. Unilateral attack involving first metatarsophalangeal joint

  2. Development of maximal inflammation within 1 day

  3. Attack of monoarticular arthritis

  4. More than 1 attack of acute arthritis

  5. Pain or swelling in first MTP joint

  6. Observation of joint redness

  7. Unilateral attack involving tarsal joint

  8. Suspected tophus

  9. Hyperuricemia

  10. Asymmetric swelling within a joint on radiograph

  11. Subcortical cysts without erosions on radiograph

  12. Negative culture of joint fluid for microorganisms during attack of joint inflammation

Any 2 of the following:

  1. Presence of urate crystals in synovial fluid or tissues

  2. Painful joint swelling, abrupt onset, clearing in 1–2 weeks initially

  3. Serum uric acid > 7 mg/dl in males or > 6 mg/dl in females

  4. Presence of tophi

Urate crystals in joint fluid or tissue or tophus *
Any 2 of the following:

  1. Response to colchicine — major reduction in inflammation within 48 h

  2. Abrupt onset and remission in 1–2 weeks initially

  3. 2 attacks of painful limb joint swelling

  4. First MTP attack

  5. Presence of a tophus

  • ↵* This criterion is sufficient for diagnosis of gout. ARA: American Rheumatism Association; MTP: metatarsophalangeal.