Acute Gout Diagnosis Rule
Aids in diagnosing acute gout using clinical and laboratory features 1.
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Male sex?
Previous patient-reported arthritis attack?
Onset within 1 day?
Joint redness?
1st metatarsophalangeal joint involvement?
Hypertension or 1 or more cardiac diseases (angina, MI, CHF, stroke/TIA, PVD)?
Serum uric acid greater than 5.88 mg/dL (0.35 mmol/L)?
使用適応
Use for adults with acute monoarthritis when synovial fluid analysis is not feasible to estimate the probability of gout and guide need for aspiration or further testing. Provides rapid bedside risk stratification using clinical features (e.g., podagra pattern, recurrent attacks, erythema, rapid onset, cardiovascular comorbidity, hyperuricemia) supported by EULAR evidence 1 [Level I evidence]. Helps differentiate gout from mimics and decide on immediate management.
洞察と注意事項
Base diagnosis on clinical likelihood only when synovial fluid analysis is not feasible. High scores increase probability, but do not exclude septic arthritis.
- Key strengths: incorporates classic features (podagra, rapid onset, prior episodes, erythema, male sex, cardiovascular disease, hyperuricemia) supported by EULAR evidence 1 [Level I evidence].
- Key cautions: specificity varies; performance decreases in established disease 2 [Level II evidence]; hyperuricemia alone is unreliable; atypical cases require imaging or aspiration.