Diagnosing Gout

Gout is a disorder of the joints similar to arthritis where too much uric acid builds up in the blood. This uric acid build-up, sometimes also called hyperuricemia, forms tiny crystals that get deposited in the joints and soft tissues of the body. Symptoms include stiff, hot, painful, and inflamed joints. Symptoms of gout are similar to psoriatic arthritis, rheumatoid arthritis, pseudogout and infection.

Gout is a chronic disease with the potential to cause long term damage. It's important to make sure you get the correct diagnosis to get the right treatments.

Blood Tests Can't Diagnose

Some doctors take blood tests to measure the levels of uric acid in the blood. While tests of blood can find uric in the blood, this is not a reliable diagnosing method. Sufferers of gout have elevated levels of uric acid in their blood at some point, but often not during a gout attack. During a gout attack, levels can be normal. It's also possible to have hyperuricemia without suffering from gout.

The Search for Crystals

It's the deposit of crystals that cause the pain of gout. Before testing for crystals is done, the doctor will take a look at your medical history. Age, weight, diet, gender and family history can be risk factors for gout. Those taking certain medications may suffer from hyperuricemia and gout.

To get the most accurate diagnosis, it's a good idea to visit your doctor during an attack. Fluid is taken from your joints and is examined under a microscope with special filters that help make the crystals visible. The process of removing the joint fluid (synovial fluid) is simple and involves numbing the skin and injecting a syringe. The process, which is officially called arthrocentesis, takes less than one minute. Examining fluid from the joints can rule out any other causes of the pain as well like infection.

Feeling for Lumps in the Joints

Those who have had gout over a long period of time may suffer from tophi underneath the skin. Tophi are hard crystallized deposits on the joints -- often on the hands, the elbows or behind the ears -- that can be visually seen or felt. Tophi can cause permanent damage to the joints which may not be visible with the naked eye but can severely hamper movement. An x-ray is usually done to see the severity of the trophi and if there's kidney stones or permanent kidney damage.