How to Test & Diagnosis Gout?

Gout can be difficult to diagnose due to its associated symptoms being vague and similar to other conditions. While recurring gout sufferers might know what to look out for or recognize when it comes to gout, a first time sufferer might not even know where to start. The best way to diagnose gout is by visiting your doctor who will have the tools and knowledge to properly exam you. If you are visiting your doctor to check for gout it's best to be prepared so that you can ensure you get the most out of your visit.

Signs Your Doctor Will Look For

During your visit, your doctor will ask you to identify any and all symptoms you might have. Based on your response, they will determine whether or not they need to perform further testing or examinations to confirm a gout diagnosis. Some signs that your doctor will look for during your examination include:

• Over-production of uric acid (hyperuricemia)
• Presence of uric acid crystals in joint fluid
• More than one attack of acute arthritis
• Arthritis that develops in a day and that produces a swollen, red, warm, inflamed joint
• Arthritis attack in only one joint, particularly the big toe, ankle or knee

Testing for Gout

Gout tests are designed to identify gout and distinguish it from other conditions or arthritis. The tests help display the amount of uric acid in the blood and can help you and your doctor investigate the cause of increased uric acid levels in the blood. Your doctor will order a gout test if they feel that your symptoms and signs align properly with gout related ailments. Tests to help diagnose gout may include:

• Synovial Fluid Analysis

Examination of the synovial fluid is the most accurate method for diagnosing gout. Your doctor will favor this test over others due to its precision and ease. Synovial fluid is a lubricating liquid that helps to cushion the joints and supplies nutrients and oxygen to the cartilage. It also the fluid where uric acid crystals (Monosodium urate crystals or MSU) primarily localize. During your test, the doctor will use a needle to draw synovial fluid from the affected joint. Anesthesia is not used during this test because it not considered too painful and it can also affect the results of the procedure. Patients who had experienced a synovial fluid analysis describe it to cause minor discomfort that quick fades away.

After the fluid is extracted, it is sent to a lab for further analysis. The lab can exam the fluid for the presence of monosodium urate crystals and this will help to confirm the diagnosis of gout. The lab can also test the fluid sample for infection to rule out other conditions.

Some concerns regarding this procedure can include: a patient having a low pain threshold which makes the extraction process difficult for them and possible infection, although this occurs in less than 0.1% of patients. Some patients have experienced reduction and inflammation thanks to the extraction process taking out the synovial fluid and accompanying monosodium urate crystals.

• Uric Acid Concentration Blood Test

A blood test is occasionally performed to measure the uric acid content in the blood and to detect hyperuricemia. While it can help identify uric acid levels, it is not always reliable in confirming the diagnosis of gout. A blood test is conducted by drawing blood from the patient and sending the sample to a laboratory.

A low concentration of uric acid in the blood makes gout less likely where as a very high level increases the probability of gout. Blood tests for gout are not usually favored due to the fact that the concentration of uric acid in the blood isn't always linked with gout. In some cases, gout patients can have normal uric acid levels. Conversely, non-gout patients can have high uric acid levels which will point to other conditions.

Blood tests are favored for monitoring purposes after a patient has been diagnosed with gout. Your doctor will want to conduct blood tests as you recover from your gout attack to help monitor your uric acid levels and reduce the risk of future gout flare ups.

• Uric Acid Concentration Urine Test

Urine tests are not the most accurate for gout diagnosis, instead they are more helpful in identifying a metabolic disorder associated with the excretion of uric acid. If the uric acid levels in the urine exceed a certain value, further tests will be ordered to determine an enzyme disorder, in addition a secondary gout test will likely be performed. Another concern that greater-than-normal uric acid in the urine displays is the likelihood of developing kidney stones.

Urine tests are conducted solely by the patient and during a 24-hour period. The first urine sample of the day is usually discarded and afterward all urine passed during the 24-hour period is collected in special containers - this also includes the first urine passing on the morning of the next day. The containers are given to the doctor or sent directly to the laboratory.

Depending on the results, your doctor will request a change of diet and lifestyle changes as well as recommend continued monitoring as your progress.

• X-Ray Examination

X-Ray examinations are often not performed for acute gout attacks. This is because x-rays do not reveal any problems during early gout stages and cannot provide much information to give a confirmed diagnosis. X-Ray examinations are more likely performed for chronic gout patients to determine the progress of the disease and to identify other health problems linked to gout, such as: tophi, joint damage and deformity and possible other sites for gout flare ups.

• MRI Examination

MRI Examinations are rarely administered due to its not providing much information regarding acute gout. Like X-Ray examinations, its usefulness lies in examining the progress of chronic gout attacks and identifying other health problems linked to gout, such as: tophi, joint damage and deformity and possible other sites for gout flare ups.

Are these tests good for chronic gout?

As a chronic gout patient you should have already considered diagnosis with a health professional. These tests would have been conducted upon your first acute gout experience. If that is not the case, the best tests for chronic gout include the synovial fluid test and a uric acid level blood test.

Can these diagnosis find out tophus gout?

X-Ray and MRI examinations have proven useful in identifying tophi or tophus gout before the acid crystal deposits begin surfacing at the skin. You are concerned about developing tophi, ensure that you have made the necessary lifestyle changes to inhibit uric acid overproduction and ask your doctor for an X-Ray or MRI examination.

Can you test for gout with a blood test?

A blood test is occasionally performed to measure the uric acid content in the blood and to detect hyperuricemia. While it can help identify uric acid levels, it is not always reliable in confirming the diagnosis of gout.

Do you have to fast for a gout test?

Similar to most testing procedures, it is recommended that you fast (refrain from eating or drinking) at least 6 hours before the test.

Can I test myself for gout at home?

Uric acid test kits are readily available online or in some pharmacies. If you find that going to a pharmacy is inconvenient, or you do not wish to purchase an in home test, I suggest you take our free gout quiz. You can find it here. Additionally, by taking this Gout Quiz you can determine your severity and receive a personalized treatment plan. As a reminder, uric acid is not always the single identifying factor for gout so it's always best to visit your doctor to receive a reliable diagnosis.

Can I buy uric acid test kit and perform the diagnosis myself? How accurate is these uric acid level testers that you can buy online?

Uric acid test kits are available online and are designed to perform as a self-test/self-diagnosis system. While they are reliable, it's important to remember that an elevated uric acid level is not always the single identifier for gout. It's recommended that you visit your doctor to receive a reliable diagnosis.

Is urine test strips better than uric acid level test?

At this time there are no recommendable urine strips that reliably test for the presence of uric acid. Additionally, urine testing is not a reliable method of testing for gout because it does not provide consistent results.

What can I expect from my gout test results?

Depending on the type of test you have performed, your results will identify the presence of monosodium urate crystals in your joint, the uric acid concentration in your blood, or the uric acid concentration in your urine.

Does pH test stripes for gout work as well?

pH levels are not a reliable identifier for gout. The best kind of test to take requires the examination of uric acid concentration or the presence of Monosodium crystals in your joints.

Is blood test for gout reliable? Can I diagnose without blood test?

A blood test is occasionally performed to measure the uric acid content in the blood and to detect hyperuricemia. While it can help identify uric acid levels, it is not always reliable in confirming the diagnosis of gout. You can be diagnosed without a blood test and have other tests performed that will provide more reliable results.

What if I have gout type symptoms but my test results came negative?

If your test for gout is negative, it's important to follow up with your doctor to identify other possible conditions such as infection, other forms or arthritis or other forms of trauma or injured incurred by your affected joint.

Can gout by diagnosed by x ray?

X-Ray examinations are often not performed for acute gout attacks. This is because x-rays do not reveal any problems during early gout stages and cannot provide much information to give a confirmed diagnosis. X-Ray examinations are more likely performed for chronic gout patients to determine the progress of the disease and to identify other health problems linked to gout, such as: tophi, joint damage and deformity and possible other sites for gout flare ups.

When is the best time to test for gout? How do I know I should test myself for gout?

Upon your visit with your doctor, based on the signs and symptoms identified during your physical examination you doctor will likely recommend a test for gout to be performed. This usually occurs upon the initial gout flare up and when the gout attack is still active.

Is ultrasound diagnosis better than others?

Ultrasound is a preferred examination for chronic gout sufferers as it can help identify joints that have been afflicted with gout in the past and can display possible joint damage and deformity.

Can you list labs that do gout diagnosis?

Please refer to our list of labs where we have organized list of labs that can do the testing for you.

What is a nursing diagnosis for gout?

Did you mean if a nurse practitioner can diagnose you? If being examined by a nurse practitioner, their diagnosis for gout will include acute/chronic pain, impaired physical mobility and lack of gout related knowledge.

How long does it take to test for the gout?

If you take a synovial fluid extraction test or blood test you will conduct and finish testing during your doctor's visit. If you are taking a urine test, it will occur over a 24 hour period.

I have heard there is gout liver function test is that something I should test for as well?

Liver function tests associated with gout are performed when your uric acid level elevates to a particular number (identified by your doctor) or if you are currently on medication for gout.

Is there a genetic test for gout?

Genetic tests for gout are performed, not to confirm the presence of gout but to identify a patient's possible risk for adverse reactions to alluopurinol, a medication used to reduce uric acid levels.