What criteria should I use to refer a patient with gout to a specialist for further management?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025Updated: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed

Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider referring a person with gout to a rheumatology service if: the diagnosis of gout is uncertain ; treatment is contraindicated, not tolerated or ineffective ; they have CKD stages 3b to 5 (GFR categories G3b to G5) ; or they have had an organ transplant .

Key References

CKS - Gout
NG219 - Gout: diagnosis and management
CKS - Knee pain - assessment

What criteria should I use to refer a patient with gout to a specialist for further management?

Key References

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