Gout Diagnosis Calculator

Score the 2015 ACR/EULAR gout classification criteria from joint pattern, episode features, serum urate, and imaging findings to see whether the 8-point classification threshold is met.

Quick Facts

Formula
2015 ACR/EULAR gout classification criteria
Sums clinical, laboratory, and imaging points; a total of 8 or more classifies as gout.
Sufficient criterion
MSU crystals or a proven tophus
Either finding alone classifies the case as gout without needing the point score.
Serum urate scoring
-4 to +4 points by band
Ideally measured 4+ weeks after a flare and off urate-lowering therapy.

Your Results

Calculated
Total score
-
ACR/EULAR points (8+ = gout)
Clinical points
-
Joint pattern + episode + tophus
Lab + imaging points
-
Urate, synovial fluid, imaging
Classification
-
Meets criteria or not

Ready

Enter the clinical, laboratory, and imaging findings, then calculate the ACR/EULAR score.

About the ACR/EULAR gout classification criteria

This calculator implements the 2015 American College of Rheumatology / European League Against Rheumatism (ACR/EULAR) gout classification criteria, a validated points-based tool for classifying gout in a patient who has had at least one episode of peripheral joint or bursa swelling, pain, or tenderness. The criteria combine clinical features, serum urate, and imaging into a single score; a total of 8 or more points meets the classification threshold.

How the score is built

  • Sufficient criterion: if monosodium urate (MSU) crystals have been identified in synovial fluid from a symptomatic joint or bursa, or in a tophus, the case is classified as gout directly, without needing the point score.
  • Clinical points: joint/bursa pattern (0-2), number of episode characteristics such as redness, inability to bear touch, and difficulty walking (0-3), time course of typical episodes (0-2), and clinical evidence of tophus (0 or 4).
  • Laboratory points: serum urate scored from -4 to +4 depending on the concentration band, and synovial fluid analysis that is negative for MSU crystals (-2, or 0 if not tested).
  • Imaging points: ultrasound double-contour sign or dual-energy CT (DECT) evidence of urate deposition (0 or 4), and conventional radiography showing gout-related erosion in the hands or feet (0 or 4).

Interpreting the result

Add the clinical, laboratory, and imaging points to get the total score. A total of 8 or more points meets the ACR/EULAR classification threshold for gout. This threshold was derived and validated against synovial fluid crystal identification as the reference standard, so it functions best as a classification and research tool rather than a bedside diagnosis on its own.

When to consult a professional

This calculator performs the standard ACR/EULAR point arithmetic; it does not replace joint aspiration, crystal identification, or a clinician's evaluation. Any diagnosis or treatment decision for suspected gout should be made with a licensed healthcare provider.

Frequently Asked Questions

What formula does this calculator use?
It applies the 2015 ACR/EULAR gout classification criteria. If MSU crystals have been identified in a symptomatic joint or bursa, or in a tophus, that sufficient criterion alone classifies the case as gout. Otherwise, points are summed across joint pattern (0-2), episode characteristics (0-3), time course (0-2), clinical tophus (0 or 4), serum urate (-4 to 4), synovial fluid analysis (-2 or 0), and imaging (0-4 each for urate deposition and erosion). A total of 8 or more points meets the classification threshold.
What does a score of 8 or higher mean?
A total score of 8 or more points meets the 2015 ACR/EULAR threshold for classifying a case as gout, a cut-off validated against synovial fluid crystal analysis. It is a classification tool designed for research and diagnostic support, not a substitute for crystal identification or clinical judgment.
Do I need a joint aspiration to use this calculator?
No. The point-based criteria were designed to classify gout when synovial fluid crystal analysis is unavailable or negative. If MSU crystals were identified, that sufficient criterion applies directly; otherwise the calculator combines clinical, laboratory, and imaging findings to reach a score.

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