www.MedicalCRITERIA.com

Home A-Z Index About Us Books Español
Sponsored Links

Sponsored Links

Criteria for the Classification of Acute Gouty Arthritis

A. Presence of characteristic urate crystals in the joint fluid, or

B. Presence of a tophus proven to contain urate crystals by chemical means or polarized light microscopy, or

C. Presence of six of the following clinical, laboratory, and radiographic phenomena:

  1. More than one attack of acute arthritis.

  2. Development of maximal inflammation within 1 day.

  3. Attack of monarticular arthritis.

  4. Observation of joint redness.

  5. Pain or swelling in first metatarsophalangeal joint.

  6. Unilateral attack involving first metatarsophalangeal joint.

  7. Unilateral attack involving tarsal joint.

  8. Suspected tophus.

  9. Hyperuricemia.

  10. Asymmetric swelling within a joint on x-ray.

  11. Subcortical cysts without erosions on x-ray.

  12. Negative culture of joint fluid for microorganisms during attack of joint inflammation.

Comparison of Gout and Pseudogout

 

Gout

Pseudogout

Ratio of men to women

7:1

1:1.5

Age group affected

Men >40 years old

Postmenopausal women

Elderly

Serum urate

Elevated

Normal

Joints involved

First metatarsophalangeal (MTP) joint, insteps, knees, wrists, fingers, olecranon bursae

Knees, wrists, ankles

Involvement of first MTP (podagra)

Common

Rare

Tophi

Present

Rare tophi-like deposits

Radiographic findings

Erosions with overhanging edges

Chondrocalcinosis

Crystals

Needle-shaped, strong negative birefringence

Rhomboid-shaped, weakly positive birefringence

 

References:

  1. Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yu TF. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum. 1977 Apr;20(3):895-900. [Medline]

  2. Schlesinger N. Diagnosis of gout: clinical, laboratory, and radiologic findings. Am J Manag Care. 2005 Nov;11(15 Suppl):S443-50. [Medline]

Sponsored Links

 

Created: March 27, 2006
Last Modified: 10/24/2010

 
MedicalCRITERIA.com 2006 all rights reserved.                                                                     Contact Us.