1977 Criteria for the Classification of Acute Arthritis of Primary Gout

1. More than one attack of acute arthritis

2. Maximum inflammation developed within 1 day

3. Monoarthritis attack

4. Redness observed over joints

5. First metatarsophalangeal joint painful or swollen

6. Unilateral first metatarsophalangeal joint attack

7. Unilateral tarsal joint attack

8. Tophus (proven or suspected)

9. Hyperuricemia

10. Asymmetric swelling within a joint on x ray*

11. Subcortical cysts without erosions on x ray

12. Monosodium urate monohydrate microcrystals in joint fluid during attack

13. Joint fluid culture negative for organisms during attack

* This criterion could logically be found on examination as well as on x ray. However the protocol did not request this information in regard to examination.

Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yü T-F. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum 1977;20:895---900.