Gout

A doctor will want to rule out other possible conditions that can cause symptoms similar to gout, such as septic arthritis and pseudogout. To confirm or disprove a gout diagnosis, a doctor may use some or all of the following:

Physical Exam

A doctor will examine the patient’s affected joint, noting skin color, swelling, pain points, and range of motion.

The doctor will also look for the presence of bumps under the skin. These are collections of uric acid crystals (monosodium urate crystals) called tophi. Tophi are a strong indicator that a person has chronic gout.

Patient Interview

A doctor will ask a patient questions about their family medical history and the onset and pattern of their symptoms.

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Joint Fluid Analysis

The most dependable way to diagnose gout is by examining the joint fluid under a microscope and looking for uric acid crystals.

To obtain a joint fluid sample, a doctor will use a needle and syringe to draw fluid from the affected joint. This procedure is called arthrocentesis or joint aspiration. The procedure may be performed using medical imaging (such as ultrasound) to ensure accurate placement of the needle. If uric acid crystals are found in the fluid sample, then a gout diagnosis is confirmed.

A small percentage of gout cases are diagnosed even though uric acid crystals are not found during joint fluid analysis.1 Before such a diagnosis, additional tests must be done to rule out other possibilities, such as septic arthritis (infectious arthritis).

• Gout medications are available in two types and focus on two different problems. The first type helps reduce the inflammation and pain associated with gout attacks. The second type works to prevent gout complications by lowering the amount of uric acid in your blood.
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• Which type of medication is right for you depends on the frequency and severity of your symptoms, along with any other health problems you may have.
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• Medications to treat gout attacks
• Drugs used to treat gout flares and prevent future attacks include:
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• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include over-the-counter options such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), as well as more-powerful prescription NSAIDs such as indomethacin (Indocin, Tivorbex) or celecoxib (Celebrex). NSAIDs carry risks of stomach pain, bleeding and ulcers.
• Colchicine. Your doctor may recommend colchicine (Colcrys, Gloperba, Mitigare), an anti-inflammatory drug that effectively reduces gout pain. The drug's effectiveness may be offset, however, by side effects such as nausea, vomiting and diarrhea.
• Corticosteroids. Corticosteroid medications, such as prednisone, may control gout inflammation and pain. Corticosteroids may be in pill form, or they can be injected into your joint. Side effects of corticosteroids may include mood changes, increased blood sugar levels and elevated blood pressure.