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2015 ACR/EULAR classification criteria for gout
Classifies gout in a patient with at least one symptomatic joint or bursa.
2015 ACR/EULAR classification criteria for gout
Entry criterion: at least one episode of swelling, pain, or tenderness in a peripheral joint or bursa
Monosodium urate crystals in a symptomatic joint/bursa or in a tophus (sufficient criterion)
Pattern of joint/bursa involvement ever affected
Episode characteristics (erythema over joint, cannot bear touch/pressure, great difficulty walking or using joint)
Typical time course (≥2 of: peak pain <24 h, resolution ≤14 days, complete resolution between episodes)
Clinical evidence of tophus
Serum urate (off urate-lowering therapy, ideally >4 weeks from an episode)
Synovial fluid analysis of a symptomatic joint/bursa
Imaging evidence of urate deposition (ultrasound double-contour sign or DECT)
Imaging evidence of gout-related joint damage (radiographic erosion)
Result0 points
Score <8 — does not meet the classification criteria for gout.
- Classification threshold
- ≥8 points
When to use
- Classifying gout in a patient with at least one episode of peripheral joint or bursal symptoms, for research or standardised diagnosis.
Formula
Applied only if the entry criterion is met. Crystal identification is sufficient. Otherwise sum weighted domains: joint pattern (0–2), episode characteristics (0–3), time course (0–2), tophus (0 or 4), serum urate (-4 to 4), synovial MSU-negative (0 or -2), imaging urate deposition (0 or 4), imaging damage (0 or 4). Score ≥8 classifies as gout.
Pearls and pitfalls
- A negative serum urate (<4 mg/dL) or MSU-negative synovial fluid subtracts points.
- These are classification, not diagnostic, criteria — clinical judgement still applies.