Acute_gout_diagnosis_rule v.1
An easy to use diagnostic rule for determining whether a patient's symptoms are due to acute gouty arthritis, and if there is need for further laboratory testing. The assessment is a clinical one that is made without joint fluid analysis. Points are assigned for each of 7 variables: sex, previous report of arthritis, onset within 1 day, joint redness, involvement of 1st metatarsophalangeal joint, cardiovascular disease and serum uric acid level. A total score <=4 is unlikely to be gout (gout prevalence 2.2%), score >4 and <8 is indeterminate (gout prevalence 31.2%), and a score >=8 is likely to be gout (gout prevalence 80.4%). Synovial fluid analysis of the affected joint for monosodium urate (MSU) crystals is recommended in the indeterminate group.
To clinically determine whether an individual's joint symptoms are due to acute gouty arthritis, and if there is need for further laboratory testing.
To calculate the acute gout arthritis score, and determine the need for further joint fluid analysis based on 7 variables: sex (2 points if male), previous report of arthritis (2 points if present), onset within 1 day (0.5 points if present), joint redness (1 point if present), involvement of 1st metatarsophalangeal joint (2.5 points if present), cardiovascular disease (1.5 points if present) and serum uric acid level (3.5 points if >5.88 mg/dl). A total score <= 4 is unlikely to be gout (gout prevalence 2.2%), score >4 and <8 is indeterminate (gout prevalence 31.2%), and a score >= 8 is likely to be gout (gout prevalence 80.4%). Synovial fluid analysis of the affected joint for monosodium urate (MSU) crystals is recommended in the indeterminate group.
Janssens HJ, Fransen J, Van de Lisdonk EH, van Riel PL, van Weel C, Janssen M. A diagnostic rule for acute gouty arthritis in primary care without joint fluid analysis. Archives of internal medicine. 2010 Jul 12;170(13):1120-6. Kienhorst LB, Janssens HJ, Fransen J, Janssen M. The validation of a diagnostic rule for gout without joint fluid analysis: a prospective study. Rheumatology. 2014 Sep 16:keu378.
OBSERVATION.basic_demographic.v1, OBSERVATION.lab_test-uric_acid.v1, OBSERVATION.history_prior_medical_diagnosis.v1, OBSERVATION.acute_gout_diagnosis_rule.v1, EVALUATION.acute_gout_diagnosis.v1
