Format

Send to

Choose Destination
J Korean Med Sci. 2019 Jun 10;34(22):e155. doi: 10.3346/jkms.2019.34.e155.

Performance of the 2015 American College of Rheumatology/European League against Rheumatism Classification Criteria for Gout in Korean Patients with Acute Arthritis.

Author information

1
Division of Rheumatology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
2
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
3
Division of Rheumatology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
4
Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
5
Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. ysong@snu.ac.kr.

Abstract

BACKGROUND:

We aimed to assess the performance of the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for gout in Korean patients with acute arthritis and to compare the performance of the ACR/EULAR criteria to that of other sets of criteria for gout classification.

METHODS:

Patients with acute arthritis who underwent diagnostic arthrocentesis at one of the four participating rheumatology clinics were consecutively enrolled between February and December 2017. Crystal-proven gout was diagnosed upon confirming the presence of monosodium urate (MSU) crystals in patients with a clinical impression of gout as judged by the rheumatologist. The performance of the ACR/EULAR and other gout classification criteria, including the Rome, New York, American Rheumatism Association (ARA), Mexico, and Netherlands criteria, was analyzed regardless of the presence/absence of MSU crystals.

RESULTS:

The study enrolled 118 gout patients (all crystal-proven) and 95 non-gout patients. According to the area under the curve, the diagnostic performance was the highest for the ACR/EULAR classification criteria (sensitivity, 80.5%; specificity, 95.8%; area under the curve, 0.966), followed by the Netherlands, Rome, ARA, New York, and Mexico criteria. All six sets of criteria demonstrated lower sensitivity in patients exhibiting the first episode of acute arthritis.

CONCLUSION:

In Korean patients with acute arthritis, the ACR/EULAR classification criteria outperformed other sets of gout classification criteria even in the absence of information regarding the presence of MSU crystals. However, to enhance diagnostic sensitivity, synovial fluid analysis should be considered in patients with the first episode of acute arthritis.

KEYWORDS:

Classification Criteria; Gout; Monosodium Urate; Sensitivity; Specificity

Supplemental Content

Full text links

Icon for Korean Academy of Medical Sciences Icon for PubMed Central
Loading ...
Support Center