Gout Classification Tool for Clinicians
2015 ACR/EULAR Classification Criteria for Gout
A structured way to review recurrent swollen joints, serum urate, MSU crystal evidence and imaging findings using the 2015 ACR/EULAR classification criteria. Not a standalone diagnosis.
This tool is for clinician education and structured classification support only. The 2015 ACR/EULAR criteria were developed for classification and should not replace clinical judgement, synovial fluid analysis where appropriate, or urgent assessment of possible septic arthritis.
Suited to structured clinical review
Recurrent acute monoarthritis or oligoarthritis
Especially episodes involving the first MTP, midfoot or ankle.
Suspected gout with unclear features
When features overlap with CPPD, reactive or psoriatic arthritis.
Structured documentation before referral
Capture clinical, laboratory and imaging findings in one record.
Consider urgent assessment for septic arthritis if there is fever, systemic illness, a severe acute hot swollen joint, immunosuppression, a prosthetic joint, or diagnostic uncertainty.
Structured classification
Work through the three steps. All scoring runs client-side; no patient data is transmitted or stored.
Entry criterion
Has the patient ever had at least one episode of swelling, pain, or tenderness in a peripheral joint or bursa?
When a rheumatology opinion may be helpful
Recurrent flares or unclear diagnosis
Young-onset gout
Tophus or erosive disease
Kidney stones or CKD complicating treatment choice
Multiple joints involved
Persistent hyperuricaemia despite treatment
Concern for inflammatory arthritis mimicking gout
How the ACR/EULAR gout criteria are structured
Step 1 checks whether the patient belongs in the population being scored.
Step 2 recognises MSU crystal evidence as sufficient for classification.
Step 3 adds weighted clinical, laboratory and imaging features.
The threshold is ≥ 8 out of a maximum 23 points.
Negative points are applied for very low serum urate and MSU-negative synovial fluid because they reduce the probability of gout.
Imaging not performed should score 0, not negative.
Source material
- Neogi T, et al. 2015 Gout Classification Criteria: an American College of Rheumatology / European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015;74:1789–1798.
- Neogi T, et al. Arthritis & Rheumatology. 2015;67(10):2557–2568.
- 2020 American College of Rheumatology Guideline for the Management of Gout — for management context only.
This tool is for clinician education and structured classification support only. The 2015 ACR/EULAR criteria were developed for classification and should not replace clinical judgement, synovial fluid analysis where appropriate, or urgent assessment of possible septic arthritis.