ACR/EULAR Gout Classification Criteria

Entry Criterion: ≥1 Episode of Peripheral Joint Swelling/Pain

Sufficient Criterion: MSU Crystals in Symptomatic Joint

Pattern of Joint Involvement

Characteristics of Episode

Time Course: Typical Episodes

Tophus

Serum Urate Level

Imaging Evidence

Result: –

Awaiting input

Select entry criterion to begin.

Provides formal diagnostic criteria for gout.

Why Use

These criteria can substitute for synovial fluid analysis (the gold standard) if fluid analysis is not possible, or if there are sufficient other criteria that the patient meets.

When to Use

Patients with mono or oligo-arthritis of unclear etiology where gout is in the differential diagnosis.

Formula

Addition of selected points.

Pearls / Pitfalls

The ACR/EULAR Classification can be used to formally diagnose gout. The criteria allow for a non-synovium diagnosis of gout (since presence of monosodium urate crystals in a symptomatic joint is the gold standard for gout) to assist clinicians when synovial testing is not possible (small joint, lab testing not available).

Management

Other causes of monoarthritis should be considered if patient does not meet criteria for gout, for example: pseudogout, septic arthritis, reactive arthritis, psoriatic, rheumatoid, or osteoarthritis.

Advice

Gout flares are often treated with some combination of steroids, NSAIDS (classically, indomethacin), opioids for extreme pain, and colchicine, depending on a patient's age and other risk factors for complications. After the initial flare, patients may benefit from urate-lowering therapies like allopurinol.