Gout Diagnosis Calculator

Created by Aleksandra Zając, MD
Reviewed by Dominika Miszewska, MD, PhD candidate and Adena Benn
Based on research by
Hein J E M Janssens, Jaap Fransen, Eloy H van de Lisdonk, Piet L C M van Riel, Chris van Weel, Matthijs Janssen A diagnostic rule for acute gouty arthritis in primary care without joint fluid analysis Archives of Internal Medicine (2010 Jul)See 1 more source
Laura B E Kienhorst, Hein J E M Janssens, Jaap Fransen, Matthijs Janssen The validation of a diagnostic rule for gout without joint fluid analysis: a prospective study Rheumatology (Oxford) (2015 Apr)
Last updated: Jun 26, 2022

If podagra diagnosis criteria give you a headache, our gout diagnosis calculator can be your painkiller! Find out everything you need to know at hand about the diagnosis and management of gout. Read on to find out:

  • What are the gout diagnosis criteria and gout risk factors;
  • The role of colchicine and allopurinol; and
  • What is the colchicine dosage in acute gout.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace a professional doctor's assessment. Consult a doctor if you think you may have gout.

Gout diagnosis criteria

Gout (or podagra) is one of the most prevalent diseases of the joints. About 1 in 25 adult persons in the US will experience gout symptoms in their life.

A gout flare is a state of acute inflammation. The affected joint, usually the first metatarsophalangeal joint (big toe joint), is red, swollen, and tender. Gout typically affects overweight males, previously diagnosed with at least one cardiovascular disease. Measuring the uric acid in the blood is helpful, as the uric acid is usually high in those patients.

To sum up, let's list the criteria used in the gout diagnosis calculator:

  • Painful joint inflammation - red, swollen, and tender first metatarsophalangeal joint (the most common area);
  • Uric acid level is high;
  • Patient is a male;
  • Patient has previously been diagnosed with cardiovascular disease or arthritis; and
  • Sudden onset of the symptoms (one day).

Using the gout diagnosis calculator

Our gout diagnosis calculator is very easy to use. Read the list of questions, and mark 'Yes' for those that are true for your patient. The result will be ready at the very bottom of the calculator.

Based on our scoring, we can differentiate three groups of patients:

  • Up to 4 points total - the prevalence of gout in this group is very low (2.2 %), and the diagnosis is improbable.
  • Between 4 and 7.5 points - the prevalence of gout is 31.2 %. You might need further testing, like the synovial fluid analysis.
  • Above 7.5 points - the diagnosis of gout is very likely; in this group, the prevalence of gout is even 80.4 %.

Treatment of acute gout and colchicine dosage

Treatment of acute and chronic gout differs a lot. For regular treatment, you want to address the high uric acid level and other inflammatory factors. In the acute gout flare-up, you want to suppress the inflammation as fast as possible.

Drugs used for acute gout treatment are:

  1. Colchicine;
  2. Non-steroidal anti-inflammatory drugs (e.g., indomethacin); and
  3. Steroids if needed (e.g., if the patient cannot tolerate colchicine and NSAIDs).

We should dose with colchicine cautiously:

  • Use 1.2 mg for the first dose;
  • Then take 0.6 mg for the second dose one hour after the first dose; and
  • In the subsequent days, use 0.6-1.2 mg of colchicine per day.

FAQ

Why does allopurinol worsen acute gout?

Allopurinol can worsen acute gout because its behavior in the body forces the uric acid crystals to move from the cartilage to the joint space. It can trigger a gout flare and worsen an ongoing one. You shouldn't begin the allopurinol treatment during an acute attack - it is better to wait about two weeks.

Is gout attack with low uric acid levels possible?

Yes, it is possible to experience a gout attack, and have a low uric acid level at the same time. The evidence says 11-49 % of patients having a gout flare have a low uric acid level.

How do you treat an acute gout flare?

To treat an acute gout flare:

  1. Use NSAIDs (non-steroidal anti-inflammatory drugs).
  2. Use colchicine if tolerated well.
  3. In case of intolerance of the previous treatments, opt for the use of steroids.
  4. Supplementary, the patient should drink plenty of fluids (at least 2 liters/day).
  5. Applying ice to the affected joint will help relieve the pain.

What causes an elevated uric acid in the blood?

Causes of high serum uric acid encompass:

  1. Alcohol use;
  2. High intake of foods such as meat, giblets, seafood, and conserved meat;
  3. High intake of fruit beverages, some types of fruits;
  4. Some hematological conditions;
  5. Impaired uric acid output - kidney conditions; and
  6. Physical activities that leave you exhausted.
Aleksandra Zając, MD
Gender
Female
Previous arthritis attack
No
Onset within one day
No
Joint redness
No
Metatarsophalangeal involvement
No
Hypertension or more than one CVD disease
No
Serum uric acid > 5.88 mg/dL (0.35 mmol/L)
No
Result
0
The diagnosis of gout is unlikely.

In this score range, there's only 2.2 % prevalence of gout.
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