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:
More than one attack of acute arthritis.
Development of maximal inflammation within 1 day.
Attack of monarticular arthritis.
Observation of joint redness.
Pain or swelling in first metatarsophalangeal joint.
Unilateral attack involving first metatarsophalangeal joint.
Unilateral attack involving tarsal joint.
Asymmetric swelling within a joint on x-ray.
Subcortical cysts without erosions on x-ray.
Negative culture of joint fluid for microorganisms during attack of joint inflammation.
Comparison of Gout and Pseudogout
|Ratio of men to women||7:1||1:1.5|
|Age group affected||
Men >40 years old
|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|
- 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]
- Schlesinger N. Diagnosis of gout: clinical, laboratory, and radiologic findings. Am J Manag Care. 2005 Nov;11(15 Suppl):S443-50. [Medline]
Created: Mar 27, 2006