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Diagnosing Gout

Gout is a common disease that has many of the same rheumatic symptoms as other diseases, such as arthritis and lupus. Diagnosing gout largely involves ruling out other diseases, mostly rheumatic ones. Since there is no specific individual diagnostic test for gout, many factors must be considered for the conclusive diagnosis, such as medical history, concurrent diseases or disorders, a list of symptoms as well as results of laboratory tests. If the improper diagnosis is made, gout may not be adequately treated and the disease may progress. The following are the diagnostic steps that your doctor may employ in his endeavor to properly diagnose your medical disorder to either decide upon or rule out gout.

Physical Exam

At your doctor appointment, your general physician or rheumatologist will record your medical history and list of symptoms. He will feel your affected arthritic joints for sensitivity, swelling and pain tolerance. He will likely look at your big toes, as most gout patients experience severe arthritic pain in this area. If the doctor finds current inflammation of joints that have been diseased with osteoarthritis or suffered injury in the past, he may take it as a red flag for gout as well. Also, if the doctor sees rapid progression of disease symptoms, he will likely take this into account for a gout diagnosis, as gout patients tend to develop their symptoms in a matter of minutes or hours as opposed to patients with other rheumatic diseases that don’t develop symptoms for many days or weeks.

Blood Test

Patients with gout-like symptoms usually go for a blood test so that their doctors could see their blood uric acid levels. Gout is caused by an excessive amount of uric acid in the body (hyperuricemia), high levels of uric acid in the blood could indicate a gout diagnosis. However, it is important to note that not all patients with hyperuricemia have gout, so it is incumbent upon doctors to pursue further diagnostic testing.

Synovial Fluid Examination

The most conclusive test for gout is the synovial fluid examination. This test analyzes the synovial fluid, which is the liquid that surrounds joints and provides them with protection and nutrients. A syringe injected into the joint perimeter draws out synovial fluid. The fluid is then sent to a laboratory for testing. If it is found that there is an abnormally elevated level of uric acid in the synovial fluid, and other diagnostic information and tests indicate the same, your doctor may conclude upon a gout diagnosis. A treatment procedure for gout involving the aspiration of synovial fluid can be done to reduce painful pressure and swelling on the tissue surrounding the aching joint.


Another way to analyze uric acid levels is to find out how much uric acid is excreted by the body via urination. Collecting and testing urine for uric acid levels can also contribute the necessary information needed for a gout diagnosis. Gout patients usually have an abnormally high output of uric acid in their urine. Typically, this test involves the collection of urine over a twenty-four hour span for a more accurate detection of uric acid output over the course of a day.

X-Ray Imaging

X-Rays can efficiently follow the progression of the disease and detect any decline in joint wellness before a physical examination ever could. X-Rays generally do not show any joint damage in mild cases or early stages of gout. However, X-rays are very valuable in finding problems, such as tophi, in more advanced stages of the disease.

The typical gout patient will undergo several forms of testing as well as a physical exam before his doctor reaches a conclusive diagnosis. Gout presents differently in each patient, so everyone will have different symptoms, lifestyle and overall health details to consider in the diagnostic process. Talk with your doctor about what tests you could undergo for your diagnosis.