Embarrassing Illnesses

There is no single test or examination that can confirm a diagnosis of gout. Instead your GP will look at your symptoms and medical history in order to make a diagnosis. There are lots of conditions than can cause joint pain and swelling. Gout is just one of over 200 different forms of arthritis (any condition which causes inflammation, pain and swelling in the joints). Your GP may therefore be unable to make a firm diagnosis straight away, and you may have to be referred for further tests. These will either help to confirm the diagnosis of gout, or rule out other conditions.

Serum uric acid

A serum uric acid test is normally carried out four to six weeks after an attack of gout. During the test, a sample of your blood will be taken from a vein in your arm. This will then be analysed to measure the amount of uric acid in your blood. A raised urate level is often a strong indication that you have developed gout. However, this test cannot definitively diagnose the condition. Some healthy people without gout have high urate levels in their blood. And, those who are experiencing an attack of gout may have a normal level of urate.

Synovial fluid

If there is doubt as to what is causing your joint pain, you may have a sample of synovial fluid taken from the affected joint. Synovial fluid helps keep the joint lubricated, and stops the bones and cartilage from rubbing against one another. The sample of fluid will be taken using a needle and syringe. It will then be looked at underneath a microscope. If you have gout, there will usually be crystals of uric acid present in the sample. This sort of test will also help to rule out any infection that may be causing your symptoms, such as septic arthritis (when a join becomes infected with bacteria).

X-ray

X-ray is rarely used to diagnose gout because the inflammation gout causes will not normally be detected using this method. However, an X-ray may be used to help rule out other conditions which affect the joints, such as chondrocalcinosis (build up of calcium crystals in the joints).

Follow up

Around four to six weeks after your gout attack has subsided, your GP may ask you to return for a follow up appointment. During this appointment, your GP will check your serum uric acid level to see if it has returned to a more normal level. They may also measure your blood pressure and check the status of any other conditions you may have. You will also be offered advice on lifestyle changes that will help minimise the risk of gout recurring.

Your GP can also provide you with an advance prescription of painkiller medication, so that you can deal with attacks of gout promptly, and without having to wait to visit your GP.