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2015 ACR/EULAR痛風分類
用途適応： structured classification after ≥1 symptomatic peripheral joint/bursa episode.
層別Classifies vs not — still not a standalone clinical diagnosis.
限界非適応： without entry criterion, or to force ULT decisions alone. · 落とし穴： forgetting negative SF (−2) or very low urate (−4). · Septic arthritis must be excluded clinically when indicated.
出典中华医学会风湿病学分会痛风诊疗规范 on zh
⚠️ ブラウザ内ローカル計算（PHI 非送信）。医師向け参考であり、臨床判断の代替ではありません。
端末内の記録。再訪リマインダー用
当直の次の一手
スコア後：シーン連算・隣接スコア・対応パスへ。ローカル参照のみ、HIS書き込みなし。
スコア/版付き；参考のみ・診療代替なし · HIS書き込みなし
方法論 · 代入例・ガイドライン要点・詳細
適用場面
適応： structured classification after ≥1 symptomatic peripheral joint/bursa episode.
入力項目
- ≥1 episode swelling/pain/tenderness in a peripheral joint or bursa · 選択
- MSU crystals in symptomatic joint/bursa or tophus (sufficient) · 選択
- Joint/bursa pattern (highest ever) · 選択
- Episode characteristics count (erythema / can't bear touch / can't use joint) · 選択
- Typical time-course episodes (≥2 of: max pain <24h, resolve ≤14d, complete intercritical resolution) · 選択
- Clinical tophus · 選択
- Serum urate (highest, ideally off ULT) · 選択
- Synovial fluid of symptomatic joint MSU-negative · 選択
- Imaging urate deposition (US double-contour or DECT) · 選択
- Radiographic gout-related erosion (hands/feet) · 選択
計算方法と公式
MSU in symptomatic joint/tophus = sufficient. Else sum domains (pattern, characteristics, time-course, tophus, urate, SF−2, imaging urate, erosion); ≥8 classifies.
Score highest category ever within each hierarchical domain; use highest urate off ULT when possible.
計算例（数値代入）
以下の数値は本ツールの入力欄に定義された例示値であり、本ページの数式でサーバー側で実際に計算したものです。計算過程を素早く確認できます。代入方法の例示のみで、臨床上の助言ではなく、実在する症例でもありません。
| ≥1 episode swelling/pain/tenderness in a peripheral joint or bursa | No |
|---|---|
| MSU crystals in symptomatic joint/bursa or tophus (sufficient) | No / not demonstrated |
| Joint/bursa pattern (highest ever) | Ankle or midfoot mono/oligo without 1st MTP (1) |
| Episode characteristics count (erythema / can't bear touch / can't use joint) | One (1) |
| Typical time-course episodes (≥2 of: max pain <24h, resolve ≤14d, complete intercritical resolution) | One typical episode (1) |
| Clinical tophus | No (0) |
| Serum urate (highest, ideally off ULT) | 6–<8 mg/dL (2) |
| Synovial fluid of symptomatic joint MSU-negative | Not done / not negative (0) |
| Imaging urate deposition (US double-contour or DECT) | Absent / not done (0) |
| Radiographic gout-related erosion (hands/feet) | Absent / not done (0) |
→ACR/EULAR GoutNot applicable
- Entry：Requires ≥1 peripheral joint/bursa symptomatic episode.
| ≥1 episode swelling/pain/tenderness in a peripheral joint or bursa | Yes (required) |
|---|---|
| MSU crystals in symptomatic joint/bursa or tophus (sufficient) | Yes — sufficient for classification |
| Joint/bursa pattern (highest ever) | 1st MTP mono/oligo (2) |
| Episode characteristics count (erythema / can't bear touch / can't use joint) | Three (3) |
| Typical time-course episodes (≥2 of: max pain <24h, resolve ≤14d, complete intercritical resolution) | Recurrent typical episodes (2) |
| Clinical tophus | Yes (4) |
| Serum urate (highest, ideally off ULT) | ≥10 mg/dL (4) |
| Synovial fluid of symptomatic joint MSU-negative | MSU-negative (−2) |
| Imaging urate deposition (US double-contour or DECT) | Present (4) |
| Radiographic gout-related erosion (hands/feet) | Present (4) |
→ACR/EULAR GoutClassifies (MSU sufficient)
- Pathway：Sufficient criterion met — score not required
結果の判読と層別
Classifies vs not — still not a standalone clinical diagnosis.
ガイドライン要点（独自整理）
- Entry gate + MSU sufficient pathway.
- ≥8 classifies.
- 次： gout flare pathway; CN gout guideline on zh.
以上は該当ガイドラインの要点を本サイトが独自に整理したものであり、原文の引用ではありません。
注意点と限界
- 非適応： without entry criterion, or to force ULT decisions alone.
- 落とし穴： forgetting negative SF (−2) or very low urate (−4).
- Septic arthritis must be excluded clinically when indicated.
照合と出典 · 検証可能なガバナンス
参考ガイドラインと出典
- [ガイドライン / 主要出典]中华医学会风湿病学分会痛风诊疗规范 on zh
- Neogi T, et al. Arthritis Rheumatol / Ann Rheum Dis 2015 · 出典 ↗
ガイドライン全文の著作権は各学会・出版社に帰属します。 · データセット整理日 2026-10-08
よくある質問
よくある質問
- 2015 ACR/EULAR痛風分類は患者データをアップロードしますか？どこで計算しますか？
- 計算はブラウザ内でローカルに行われ、入力と結果はサーバーに送信されません。免許を有する医師向けであり、病歴・検査・施設プロトコルと合わせて解釈すること。診断や処方の代替ではありません。
- 2015 ACR/EULAR痛風分類は実際にどう計算しますか？計算例を示せますか？
- 代入値: ≥1 episode swelling/pain/tenderness in a peripheral joint or bursa No、MSU crystals in symptomatic joint/bursa or tophus (sufficient) No / not demonstrated、Joint/bursa pattern (highest ever) Ankle or midfoot mono/oligo without 1st MTP (1)、Episode characteristics count (erythema / can't bear touch / can't use joint) One (1)、Typical time-course episodes (≥2 of: max pain <24h, resolve ≤14d, complete intercritical resolution) One typical episode (1)、Clinical tophus No (0)、Serum urate (highest, ideally off ULT) 6–<8 mg/dL (2)、Synovial fluid of symptomatic joint MSU-negative Not done / not negative (0)… → 結果: ACR/EULAR Gout Not applicable（Entry: Requires ≥1 peripheral joint/bursa symptomatic episode.） 代入値: ≥1 episode swelling/pain/tenderness in a peripheral joint or bursa Yes (required)、MSU crystals in symptomatic joint/bursa or tophus (sufficient) Yes — sufficient for classification、Joint/bursa pattern (highest ever) 1st MTP mono/oligo (2)、Episode characteristics count (erythema / can't bear touch / can't use joint) Three (3)、Typical time-course episodes (≥2 of: max pain <24h, resolve ≤14d, complete intercritical resolution) Recurrent typical episodes (2)、Clinical tophus Yes (4)、Serum urate (highest, ideally off ULT) ≥10 mg/dL (4)、Synovial fluid of symptomatic joint MSU-negative MSU-negative (−2)… → 結果: ACR/EULAR Gout Classifies (MSU sufficient)（Pathway: Sufficient criterion met — score not required）
照合手順
照合と根拠
本ツールの数式と計算方法は本ページに明示しており、公開のうえ逐一照合できます。数式・係数・閾値は上記の権威ある情報源に基づき照合しています。 臨床ツール一覧 →