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Score of Schumacher et al for Evaluating a Patient with an Attack of Acute Gouty Arthritis

Purpose: To evaluate a patient with acute gouty arthritis using the score of Schumacher et al.

Description

Schumacher et al used a score to evaluate therapeutic outcome following treatment of a patient with acute gouty arthritis. This can be used to evaluate the patient before and after an intervention. The authors are from Merck Research Laboratories and the Universities of Pennsylvania and California at San Francisco.


Parameters:

(1) pain

(2) tenderness on palpation or passive motion

(3) swelling

 

Other measures:

(4) erythema

(5) patient's global assessment of response to treatment

(6) provider's global assessment of response to treatment

 

Parameter

Finding

Points

pain

none

0

 

mild

1

 

moderate

2

 

severe

3

 

extreme

4

tenderness

no tenderness

0

 

patient complains of pain

1

 

patient complains of pain and winces

2

 

patient complains of pain, winces and withdrew joint

3

swelling

none

0

 

slight

1

 

moderate

2

 

bulging beyond joint margins

3

 

Erythema is reported as present or absent and no points were assigned.

 

where:

• The grading of tenderness seems similar to that from Doyle et al (1981) for grading tenderness in osteoarthritis.

• The original grading for erythema was just present or absent. It would be simple to grade this from 0-3 for none to marked. In theory this would directly correlate with the other measures.

 

Global Assessments of Response

Points

excellent

4

very good

3

good

2

fair

1

poor

0

 

total examination score =

= SUM(points for all 3 examination parameters)

 

Interpretation:

• minimum examination score: 0

• maximum examination score: 10 (13 if elect to score erythema)

• The higher the score the more severe the attack.


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Specialty

Objective

ICD-10