How is Gout Diagnosed?

Gout may prove difficult for doctors to diagnose because the symptoms of gout such as pain and swelling in a joint may resemble other conditions such as rheumatoid arthritis and a joint infection. Although, most people with gout generally have hyperuricemia (a high level of uric acid in their blood) at some point during the course of their disease, it doesn't mean hyperuricemia can be used confirm the diagnosis of gout. Since most people with hyperuricemia never suffer from gout, which adds to the difficulty of diagnosing this disease.

Tests for Gout

You might suspect that you have gout if you have a history of sudden painful sensation in one of your joints. Gout most often affects the big toe. Unlike other arthritis conditions, such as systemic lupus and rheumatoid arthritis, that simultaneously attack multiple joints, gout affects one joint at a time.

The most effective test for gout is arthrocentesis, which is also known as joint aspiration. Arthrocentesis allows your doctor to examine your joint fluid for the presence of uric acid crystals. The test generally is conducted in the comfort of you're doctor's office under a local anesthesia. Your doctor will insert a syringe in your affected joint to collect a sample of synovial fluid. Synovial fluid acts as a lubricant for your joints. Your doctor will examine the fluid for uric acid crystals and bacteria under a polarizing microscope. If bacteria appear in your synovial fluid it means you're suffering from a joint infection.

If uric acid crystals fail to show up in your fluid your doctor might analyze the sodium urate deposits (tophi) around your joints to diagnose gout. To do this, your doctor will X-ray your affected joint to check for tophi crystal deposits and whether there is any bone damage caused by the tophi.

The other kinds of test that your doctor may perform include: an urine test and a blood test. The urine test measures the amount of uric acid that you excrete. The blood test measures the level of uric acid in your blood. A high level of uric acid level in any of these two tests should raise your suspicion of gout.

Some people with a family history of gout and classical gout symptoms may be diagnosed with gout, without receiving an arthrocentesis or any other test. However, establishing a confirm diagnosis is in your best interest because many other arthritis conditions resemble gout. The most common misdiagnosis of gout is pseudogout.

What is Pseudo gout?

Pseudogout is a type of arthritis that causes a sudden and painful sensation in one of your many joints. Pseudogout usually attacks the bigger joints, like the knees and often affects older adults. Pseuodogout produces similar symptoms to gout, however it's caused by a different type of crystal deposit (i.e. calcium pyrophosphate dihydrate crystals).