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Part II. Clinical Scenario Staging Form
Country
*
Center ID
*
Patient ID
*
Date
*
DD slash MM slash YYYY
Number of tophi on physical examination
*
No tophi
1 joint
2-4 joints
>= 5 joints
If with tophi, are they stable?
*
For this purpose, unstable tophi is defined as drainage, destructive effects (deformity), high risk of infection, rapid growth, severe inflammation
Yes
No
If with stable, describe symptoms experienced by patient
*
lntermitllent (not continuous and can be described as sporadic is solated or patchy)
Chronic (persistent and long standing, lasting 6 or more weeks)
Frequency of symptoms during the PAST YEAR ?
*
1 symptom/year
2 - 6 symptoms/year
7 or more symptoms/year
Clinical Scenario
Clinical Scenario
*
Please enter the Clinical Scenario based on the algorithm shown above
Please enter a number from
1
to
9
.
