A diagnosis of gout is typically made once a medical professional has reviewed the patient’s symptom history and the results of two tests that can help diagnose the condition. A joint fluid test and a blood test that measures the uric acid level in the blood are often ordered when gout is suspected. The diagnosis can be confirmed by the manifestation of a red, tender, and swollen joint, often the big toe’s metatarsal-phalangeal joint. Once a diagnosis of gout has been made, a doctor may recommend either conventional or alternative treatment options depending on the patient’s overall heath and personal preferences.
Before giving a patient a diagnosis of gout, a doctor will often begin by reviewing the patient’s history of symptoms. Gout commonly causes acute joint pain as well as redness, inflammation, and lasting tenderness. The pain usually begins suddenly at night when the body’s temperature drops and is the most intense during the first day of the attack.
A doctor may also examine the joints most commonly affected by gout for swelling, redness, and tenderness. Gout affects the big toe’s large joint in more than half of patients. The feet, knees, and hands, as well as wrists and ankles, are also vulnerable to an attack of gout.
If there is evidence of joint swelling that conforms to the typical presentation of gout, additional diagnostic tests may be ordered. The joint fluid test involves extracting joint fluid from the swollen joint with a needle. The extracted fluid is then examined for monosodium urate crystals. Gout can be caused by the sharp urate crystals that accumulate around a joint when the kidneys don’t excrete enough uric acid or when the body makes too much uric acid.
A simple blood test can measure the level of uric acid in a person’s blood. Too much uric acid in the blood will encourage the growth of urate crystals. Neither the absence of urate crystals nor the presence of high levels of uric acid in the blood alone can confirm a diagnosis of gout.
Gout can be difficult to diagnose because some of the symptoms mimic other conditions, such as septic or rheumatoid arthritis and pseudogout. A patient suspected of suffering from gout who fails to improve with treatment may be tested for one of these similar but distinct conditions. The presence of signs of infection, such as bacteria and fever, can help differentiate other conditions from gout.
An initial attack of gout will often resolve in a few days or weeks. Without treatment, subsequent attacks of gout can occur. Additional attacks can be increasingly painful and damaging to joint tissue. A diagnosis of gout often results in treatment with medications that block the production of uric acid or facilitate its removal or with drugs that reduce inflammation and soothe pain. Alternative gout treatments include coffee, vitamin C, and cherries.
