Gout Diagnosis Calculator

What Is the Acute Gout Diagnosis Rule?

The Acute Gout Diagnosis Rule is a validated clinical score that estimates the probability of acute gout using history, examination, and serum uric acid. It helps clinicians decide when synovial fluid analysis or empiric treatment is appropriate in monoarticular arthritis. This tool sums weighted criteria and maps the total to low, intermediate, or high diagnostic probability.

Scoring Criteria

Male sex adds 2 points. A prior patient-reported arthritis attack adds 2 points. Onset within one day adds 0.5 points. Joint redness adds 1 point. Involvement of the first metatarsophalangeal (MTP) joint adds 2.5 points. Hypertension or cardiovascular disease adds 1.5 points. Serum uric acid above 5.88 mg/dL adds 3.5 points. The maximum possible score is 13 points when all criteria are present.

Interpretation

A score of 4 or below suggests gout is unlikely, with about 2.2% probability in derivation cohorts. Scores from 4.5 to 7.5 indicate intermediate probability (about 31.2%). A score of 8 or above makes gout likely, with roughly 80.4% probability. Definitive diagnosis still requires clinical correlation and, when feasible, crystal identification in synovial fluid.