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The diagnostic value of the proposal for clinical gout diagnosis (CGD)

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Abstract

The purpose of this study is to determine the diagnostic properties of the clinical gout diagnosis (CGD) proposal in patients with gout and other rheumatic diseases. We investigated the presence of current or past history of the previously published CGD criteria: (1) >1 attack of acute arthritis, (2) mono/oligoarthritis attacks, (3) rapid progression of pain and swelling (<24 h), (4) podagra, (5) erythema, (6) unilateral tarsitis, (7) probable tophi, and (8) hyperuricemia. CGD was established in patients with greater than or equal to four out of eight of these criteria. Demographic data and comorbidities were also considered. Statistical analysis included diagnostic test evaluation (sensitivity, specificity, likelihood ratios, positive predictive values and receiving operating characteristic curves). One hundred and sixty-seven patients with the following diagnoses were included: gout (most in intercritical period, n = 75), rheumatoid arthritis (RA, n = 30), osteoarthritis (OA, n = 31) and spondyloarthritis (SpA, n = 31). All gout patients had MSU crystal demonstration and constituted the gold standard for diagnostic test evaluation. There were significant differences across diagnostic groups in most demographic variables and comorbidity. The presence of greater than or equal to four out of eight of the CGD criteria were found in 97% patients with gout, in two patients with SpA, and one each with RA and OA. The sensitivity, specificity, and LR+ of greater than or equal to four out of eight of the CGD criteria were 97.3%, 95.6%, and 22.14, respectively. The presence of more than or equal to four out of eight items from the CGD proposal is highly suggestive of gout.

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Authors and Affiliations

  1. Rheumatology Department, Hospital General de México, Mexico City, Mexico

    Janitzia Vázquez-Mellado, Claudia B. Hernández-Cuevas, Everardo Alvarez-Hernández, Ingris Peláez-Ballestas, Julio Casasola-Vargas, Sergio García-Méndez & Rubén Burgos-Vargas

  2. Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico

    Janitzia Vázquez-Mellado & Rubén Burgos-Vargas

  3. Rheumatology Department, Hospital General de Zona 194, Instituto Mexicano del Seguro Social, Mexico City, Mexico

    Lucio Ventura-Rios

  4. Servicio de Reumatología, Hospital General de México, Dr. Balmis 148, Col. Doctores, Mexico, Federal District, Mexico, 06726

    Janitzia Vázquez-Mellado

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  1. Janitzia Vázquez-Mellado
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  2. Claudia B. Hernández-Cuevas
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  3. Everardo Alvarez-Hernández
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  4. Lucio Ventura-Rios
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  5. Ingris Peláez-Ballestas
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  6. Julio Casasola-Vargas
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  7. Sergio García-Méndez
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  8. Rubén Burgos-Vargas
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Correspondence to Janitzia Vázquez-Mellado.

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Vázquez-Mellado, J., Hernández-Cuevas, C.B., Alvarez-Hernández, E. et al. The diagnostic value of the proposal for clinical gout diagnosis (CGD). Clin Rheumatol 31, 429–434 (2012). https://doi.org/10.1007/s10067-011-1873-4

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  • DOI: https://doi.org/10.1007/s10067-011-1873-4

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