Wallace and other members of the American Rheumatism Association (ARA) Gout Classification Criteria Subcommittee developed criteria for the diagnosis of the acute arthritis associated with primary gout.
A diagnosis of acute gouty arthritis can be made if one or more of the following are present:
(1) presence of urate crystals in the joint fluid
(2) a tophus shown to contain urate crystals by chemical analysis or light microscopy
(3) 6 or more of 12 clinical, laboratory and radiographic features (below)
Features (from Tables 1 and 5):
(1) more than 1 attack of acute arthritis
(2) maximum inflammation developed within 1 day
(3) monoarthritis attack
(4) redness observed over joints
(5) first metatarsophalangeal joint painful or swollen
(6) unilateral first metatarsophalangeal joint attack
(7) unilateral tarsal joint attack
(8) tophus proven or suspected
(9) hyperuricemia
(10) asymmetric swelling within a joint as seen on X-ray
(11) subcortical cysts without erosions on X-rays
(12) joint fluid culture negative for micro-organisms during the attack
Performance:
• 97.8% of gout patients in study group were correctly identified.
