Diagnosing Gouty Arthritis

Gout can mimic the symptoms of the following conditions:

• Pseudogout - one of the most misunderstood forms of arthritis, a disease that mimics gout but affects larger joints.
• Psoriatic arthritis - causes swelling and pain in joints. It also causes a scaly rash on the skin.
• Rheumatoid arthritis - an autoimmune disease that causes chronic inflammation of the joints.
• Infection

A proper diagnosis is therefore essential. Tests from your doctor will include:

Diagnosis usually begins with a review of family medical history and a physical examination. The presence of tophi below the skin and red shiny skin above the affected area can indicate gout. However a more thorough medical examination is required to eliminate the possibility of the other conditions listed above.

A blood test can be used to measure levels of uric acid in the blood. This is not a reliable method for diagnosing gout. During a gout attack blood uric acid levels can lie within the normal range. Also, high uric acid levels don't always indicate the presence of gout.

X-rays can be taken to show tophi crystals around the joints and under the skin. However, X-rays of affected joints often show the joints to be normal so may not help in the diagnosis.

A more reliable method of diagnosis uses arthrocentesis. Using a syringe and needle a synovial fluid sample is taken from an affected joint. The synovial fluid is analysed under a microscope. The presence of monosodium urate (MSU) crystals in the fluid indicates the presence of gout.