For a study, researchers aimed to find a reliable way to assess radiographic damage in chronic gout patients. A gold standard rheumatologist consensus global score was comparable to renowned scoring techniques such as the Sharp/van der Heijde erosion and narrowing scores, Ratingen destruction score, and Steinbrocker score to see which one better indicated radiographic deterioration in particular joints. In the study, 95 proximal interphalangeal joints from 12 patients with gout were examined. The sites to be included in a scoring system and the additional features to be recorded were determined by scoring hand and foot radiographs from an additional 35 gout patients. The combination of the Sharp/van der Heijde erosion and narrowing scores is best associated with the consensus global score for individual joints. Furthermore, the combined Sharp/van der Heijde erosion and narrowing score had the narrowest bounds of the agreement. Chronic gout affected all joint areas in the Sharp/van der Heijde rheumatoid arthritis score, as well as the distal interphalangeal joints, and contributed to the total score. Extraarticular erosions, joint space widening, and ankylosis occurred seldom, and assessing these traits had no effect on the overall score’s dependability. The whole score had a good level of reliability: the intraclass correlation coefficient for intraobserver reproducibility was 0.993–0.998, and the intraclass correlation coefficient for interobserver reproducibility was 0.963–0.966. In chronic gout, a modified Sharp/van der Heijde method accurately and consistently portrays radiographic joint destruction.