The American College of Rheumatology (ACR) developed guidelines in 2012 for the management of patients with gout. One element involved describing the patient during an acute episode. The authors are from universities and medical centers around the United States.
Patient selection: acute gout attack
Parameters:
(1) pain intensity based on a 10 cm VAS scale (from 0 to 10)
(2) time since onset in hours
(3) extent of an attack based on number and types of joints affected
|
Pain on 10 cm VAS |
Attack Intensity |
|
0 to 4 |
mild |
|
7 to 10 |
severe |
|
> 4 and < 7 |
moderate |
|
Hours Since Onset |
Attack Duration |
|
< 12 hours |
early |
|
12 to 36 hours |
well-established |
|
> 36 hours |
late |
|
Small Joints |
Large Joints |
Body Regions |
Total Joints |
Extent |
|
1 or a “few” |
0 |
NA |
NA |
group 1 |
|
NA |
1 or 2 |
NA |
NA |
group 2 |
|
NA |
3 or more |
NA |
NA |
group 3 (poly-articular) |
|
>= 0 |
>= 0 |
2 or more |
>= 4 |
group 3 (poly-articular) |
Large joints include:
(1) shoulder
(2) elbow
(3) wrist
(4) hip
(5) knee
(6) ankle
Body regions – large joints (above) plus:
(1) forefoot (toes, metatarsals)
(2) midfoot (tarsal joints)
(3) fingers
(4) other
Specialty: Surgery, orthopedic
