| Presence of MSU crystals in a symptomatic joint or bursa (i.e., in synovial fluid) or tophus |
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| Pattern of joint/bursa involvement during symptomatic episode(s) ever |
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Characteristics of symptomatic episode(s) ever:
1).Erythema overlying affected joint (patient-reported or physician-observed) 2).Can’t bear touch or pressure to affected joint 3).Great difficulty with walking or inability to use affected joint |
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Time-course of episode(s) ever:
Presence (ever) of ≥2, irrespective of anti-inflammatory treatment:
1).Time to maximal pain <24 hours 2).Resolution of symptoms in ≤14 days 3).Complete resolution (to baseline level) between symptomatic episodes |
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Clinical evidence of tophus:
Draining or chalk-like subcutaneous nodule
under transparseInt skin, often with overlying vascularity, located in typical
locations: joints, ears, olecranon bursae, finger pads, tendons (e.g., Achilles). |
Serum urate:
Measured by uricase method. Ideally should be scored at a time
when the patient was not taking urate-lowering treatment and patient was
beyond 4 weeks of the start of an episode (i.e., during intercritical period); if
practicable, retest under those conditions. The highest value irrespective of
timing should be scored. |
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Synovial fluid analysis of a symptomatic (ever) joint or bursa:**
Should be assessed by a trained observer. |
Imaging evidence of urate deposition in symptomatic (ever) jointor bursa:
Ultrasound evidence of double-contour sign¶ or DECT demonstrating
urate deposition§. |
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Imaging evidence of gout-related joint damage:
Conventional
radiography of the hands and/or feet demonstrate at least one erosion.
‡‡ |
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