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Table 1 Overview of the criteria and cutoffs used in historical algorithms to diagnose gout

From: Validity of gout diagnosis in Swedish primary and secondary care - a validation study

Criteria Rome 1963 New York 1966 ARA 1977 Mexico 2010 Netherlands 2010
Cutoff for gout classification ≥2 of 4 criteria ≥2 of 4 criteria 6 of 12 criteria OR presence of MSU in SF 4 of 8 criteria OR presence of MSU in SF >8 pointsa
Serum uric acid, μmol/L, Male >420 female >360   >2 SD normal >2 SD normal >350 (3.5 points)
Presence of tophi X X X X X (13 points)
MSU crystals in SF or tissue x   (x)   
History of attacks of painful joint swelling with abrupt onset and resolution within 2 weeks ≥2 attacks ≥2 attacks    
A history or observation of podagra   X   X  
Rapid response to colchicine treatment, defined as a major reduction in the objective signs of inflammation within 48 h   X    
More than one attack of acute arthritis    X X  
Maximum inflammation developed within 1 day    X X X (0.5 point)
Oligoarthritis attack    X   
Redness observed over the joints    X X X (1 point)
First MTP joint painful or swollen    X   
Unilateral first MTP joint attack    X   
Unilateral tarsal joint attack    X X  
Asymmetrical swelling within a joint on X-ray    X   
Subcortical cysts without erosions on X-ray    X   
Joint culture negative for organisms during attack    X   
Mono and/or oligoarticular attacks     X X (2 points)
Male sex      X (2 points)
MTP1 involvement      X (2.5 points)
Hypertension or more than one cardiovascular diseaseb      X (1.5 points)
  1. aA summed score of 4 or less excludes gout; 8 or more suggests gout; between 4 and 8 suggests the need for SF analysis
  2. bCardiovascular disease was defined as angina pectoris, myocardial infarction, heart failure, cerebrovascular accident, transient ischemic attack or peripheral vascular disease
  3. Abbreviations: MSU monosodium urate, MTP metatarsophalangeal, SF synovial fluid