How do you assess for gout?

How is gout diagnosed? A medical doctor diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint.

What blood test is used for gout?

If you have symptoms of gout, you need to test a uric acid blood test, which measures how much uric acid you have in your blood. You may also hear this test called a serum uric acid test, serum urate, or UA.

What is the best diagnostic method for gout?

Tests to help diagnose gout may include:

• Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint.
• Blood test. Your doctor may recommend a blood test to measure the levels of uric acid in your blood.
• X-ray imaging.
• Ultrasound.
• Dual-energy computerized tomography (DECT).

What is Tophaceous gout?

Tophaceous gout occurs when uric acid crystals form masses of white growths that develop around the joints and tissues that gout has affected. These masses, called tophi, are often visible under the skin and tend to look like swollen nodules. The material may be in a liquid, pasty, or chalky state.

When to test for gout without joint fluid?

The probability of gout is uncertain with scores between 4 and 8, warranting further diagnostic testing or joint fluid aspiration. Adapted with permission from Kienhorst LB, Janssens HJ, Fransen J, Janssen M. The validation of a diagnostic rule for gout without joint fluid analysis: a prospective study. Rheumatology (Oxford). 2015;54 (4):612.

What is the positive predictive value for gout?

Table 1. note: Gout is unlikely with a score ≤ 4 (negative predictive value = 0.95); gout is likely with a score ≥ 8 (positive predictive value = 0.87). The probability of gout is uncertain with scores between 4 and 8, warranting further diagnostic testing or joint fluid aspiration.

What are the findings of joint fluid analysis?

Typical joint fluid analysis findings include: Further investigations for suspected inflammatory joint effusion include: Antibodies (e.g. anti-CCP, rheumatoid factor – both typically positive in rheumatoid arthritis) X-ray of the joint: may reveal joint erosions/destruction Typical clinical features of septic joint effusion include:

Which is the best diagnostic tool for gout?

1. Hainer BL, Matheson E, Wilkes RT. Diagnosis, treatment, and prevention of gout. Am Fam Physician. 2014;90 (12):831–836. 2. Janssens HJ, Fransen J, van de Lisdonk EH, van Riel PL, van Weel C, Janssen M. A diagnostic rule for acute gouty arthritis in primary care without joint fluid analysis. Arch Intern Med. 2010;170 (13):1120–1126. 3.