How is gout diagnosed?

Gout cannot be diagnosed simply from a blood test, since many people may have elevated blood uric acid levels, but never develop gout. Rather, gout is best diagnosed from the fluid aspirated from an inflamed swollen joint. The fluid is examined under a polarized microscope for the presence of monosodium urate crystals. Gout can be suspected based on the clinical presentation or certain imaging studies.

Fluid is aspirated through a needle from the inflamed joint during a procedure called arthrocentesis. Removing the fluid may reduce pressure within the joint and thereby reduce pain. A lack of crystals does not necessarily rule out a diagnosis of gout. Occasionally, crystals may not be observed the first time, but may be seen if fluid is removed at another time during a subsequent attack.

Since gout can cause debilitating joint pain and in the long term joint damage, it is extremely important that an accurate diagnosis be made. Then, your doctor can prescribe the appropriate specific treatment.

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