The criteria are based on selected items from:
(1) the American Rheumatism Association (ARA, later American College of Rheumatology or ACR) proposed criteria
(2) the European League Against Rheumatism (EULAR) Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT)
The diagnosis of chronic gout can be made if one or both of the following are present:
(1) monosodium urate (MSU) crystals are seen in tophi or synovial fluid
(2) 4 or more of the following are present
(2a) 2 or more attacks of acute arthritis (ARA 1)
(2b) mono- or oligo-arthritis attacks (ARA 3)
(2c) rapid progression (< 24 hours) of pain and swelling (ARA 2, EULAR 1)
(2d) podagra (EULAR 3)
(2e) erythema (EULAR 2)
(2f) unilateral tarsitis (ARA 7)
(2g) tophi (ARA 8, EULAR 4)
(2h) hyperuricemia (ARA 9, EULAR 5)
where:
• Podagra is gouty pain in the great toe.
