Table 1.

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

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)

^aA summed score of 4 or less excludes gout; 8 or more suggests gout; between 4 and 8 suggests the need for SF analysis

^bCardiovascular disease was defined as angina pectoris, myocardial infarction, heart failure, cerebrovascular accident, transient ischemic attack or peripheral vascular disease

Abbreviations: MSU monosodium urate, MTP metatarsophalangeal, SF synovial fluid