Diagnosing Gout

Gout can mimic the symptoms of the following conditions:

  • Pseudogout
  • Psoriatic arthritis
  • Rheumatoid arthritis
  • Infection

A proper diagnosis is therefore essential.

Diagnostic Procedures Methods & Techniques

Physical examination and review of medical history.
Diagnosis usually begins with a review of family medical history and a physical examination.
The presence of tophi below the skin and red shiny skin above the affected area can indicate gout. However a more thorough medical examination is required to eliminate the other conditions listed above.
Blood test.
A blood test can be used to measure levels of uric acid in the blood. This is not a reliable method for diagnosing gout. During a gout attack blood uric acid levels can lie within the normal range. Also, high uric acid levels don't always indicate the presence of gout.
X-rays can be taken to show tophi crystals around the joints and under the skin. However, X-rays of affected joints often show the joints to be normal so may not help in the diagnosis.
A more reliable method of diagnosis uses arthrocentesis. Using a syringe and needle a synovial fluid sample is taken from an affected joint. The synovial fluid is analysed under a microscope. The presence of monosodium urate (MSU) crystals in the fluid indicates the presence of gout.