1. the acute attack of arthritis, manifested by rapid onset of severe pain, swelling and pressure, peaking at 6-12 hours, especially redness of the skin surface, is highly suggestive of crystal inflammation, although it is not specific for the diagnosis of gout. The strength of recommendation and 95% confidence interval are 88 and 80-96, respectively. 2. With typical gout (such as recurrent gouty foot), the clinical diagnosis alone should be accurate, but the presence of crystals cannot confirm the diagnosis of gout without confirmation. The strength of recommendation and 95% confidence interval are 95 and 91-98, respectively.3. The presence of urate crystals confirmed in synovial fluid or gout stone aspirate confirms the diagnosis of gout. The strength of recommendation and 95% confidence interval are 96 and 93-100, respectively.4. Routine search for urate crystals in the synovial fluid is recommended for all undiagnosed inflammatory arthritis. The strength of recommendation and 95% confidence interval are 90 and 83-97, respectively. 5. Asymptomatic intra-articular confirmation of urate crystals confirms the diagnosis of interstitial gout. The strength of recommendation and 95% confidence interval are 84 and 78-91, respectively. 6. Gout and sepsis can coexist, so when septic arthritis is suspected, gram stain and synovial fluid culture should be performed even if the presence of urate crystals is confirmed. The strength of recommendation and 95% confidence interval are 93 and 87-99, respectively.7. As the most important risk factor for gout, high or low blood uric acid cannot confirm or exclude gout, because many people with hyperuricemia do not develop gout, and blood uric acid levels can be normal during acute attacks of gout. The strength of recommendation and 95% confidence interval are 95 and 92-99, respectively.8. Renal uric acid secretion should be measured in some patients with gout, especially in young patients with a family history of gout (those younger than 25 years of age) or those with kidney stones. The strength of recommendation and 95% confidence interval are 72 and 62-819, respectively. Although radiography is useful for differential diagnosis and can show typical features of chronic gout, it is not helpful in confirming the diagnosis of early or acute gout. The strength of recommendation and 95% confidence interval are 86 and 79-94, respectively.10. Risk factors for gout and related complications including metabolic syndrome (obesity, hyperlipidemia, hyperglycemia, hypertension) should be evaluated. The strength of recommendation and 95% confidence interval are 93 and 88-98, respectively.