How to Diagnose Gout?
Unfortunately, diagnosing your first gout attack often involves a needle. To accurately diagnose gout, your doctor will need to order a test on fluid he or she removes from the distressed area. Fortunately, you will only have to endure the needle for a few seconds.
Why Is the Needle Necessary to Diagnose Gout?
The easiest way to find out what is going on in the toe is to remove some synovial fluid—a liquid that keeps the joint tissues lubricated. The best way to remove synovial fluid is with a needle.
Gout results when uric acid builds up in a joint. The uric acid turns into crystals that invade the joint and cause inflammation in the ligaments, cartilage, bones, and other tissues. The uric acid crystals also infiltrate the synovial fluid.
If you lose a little synovial fluid, your body can easily replace it. Furthermore, removing a little fluid hurts less than removing bone or cartilage. A physician, physician assistant, or nurse practitioner carefully extracts a small sample of your synovial fluid with a needle and sends it to a lab. If the sample contains uric acid crystals, you indeed have gout.
Does the Needle Hurt?
While it is a quick procedure, you need to be ready for it to hurt. The skin surrounding a gout-inflamed joint is often extremely sensitive. The good news is that you will probably only need to have this procedure once—on your first gout attack.
Are There Other Diagnostic Options for Gout?
While testing synovial fluid is the gold standard for diagnosing gout, some physicians choose to use a criteria developed by the American College of Rheumatology and adopted by the American Academy of Family Physicians1.
If you have six or more of these symptoms, your doctor can diagnose gout.
- Lop-sided joint swelling on x-ray
- Blood test showing high uric acid levels
- Joint fluid culture negative for organisms during gout attack
- Maximum joint inflammation developed within a day
- Arthritis in only one joint
- More than one attack of acute arthritis
- Painful/swollen first big toe joint
- Redness over joints
- X-rays that identify subcortical cysts without erosions
- Tophi (little bumps caused by uric acid deposits)
- A gout-like attack of on both big toe joints at the same time
- A gout-like attack of on both ankle joints at the same time
Why Is an Absolute Gout Diagnosis So Important?
Gout shares many common symptoms with joint infections and other types of arthritis, and it requires tailor-made treatment. By getting an accurate diagnosis of gout, you and your doctor can start working on effective treatments to stop the gout attack, get beyond the hurt, and recover.