Overview
Gout is a form of arthritis that comes on suddenly and severely. It can affect anyone who has a buildup of uric acid in their joints.
There are many forms of arthritis. Most types share common symptoms, including joint pain and inflammation. However, different types of arthritis require different types of treatment. What works for osteoarthritis may not help your gouty arthritis. Therefore, an accurate diagnosis is essential.
Signs of gout usually come on without warning, often overnight. Symptoms can include:
- Joint pain: Gout joint pain is often intense. It’s most severe within the first 12 hours of the onset of symptoms, and it usually affects the large joint of the big toe. Other joints in the feet, hands, knees, ankles, and wrists can also be affected.
- Inflammation and redness: The affected joints will often become red, swollen, and tender to the touch.
- Decreased mobility: As gout progresses, it may limit your range of motion.
- General discomfort: After the severe pain of a gout attack subsides, you may experience joint soreness and discomfort for several days to weeks after.
All of these symptoms will help your doctor diagnose you with gout.
Gout is usually diagnosed after an acute attack of gout symptoms. Many doctors will not make a positive diagnosis of gout until you’ve had at least two episodes of acute symptoms.
After a physical examination and medical history, your doctor may order tests to confirm the diagnosis.
Uric acid blood test
The first step in diagnosing gout is usually a uric acid blood test. High uric acid levels are associated with gout. However, it’s important to note that you can have high uric acid levels and not have gout. In addition, blood uric acid may be normal during an acute attack. This test is a good starting point. It can be used to monitor your progress in lowering your uric acid level, but it’s not diagnostic by itself.
Joint aspiration
A joint aspiration is usually the next step. This test involves removing a sample of fluid from the affected joint and examining it under a microscope for urate crystals.
X-rays
If you have persistent joint disease or tophi under the skin and your doctor suspects chronic gout, an X-ray may help with the diagnosis. This will show if there are lesions or permanent damage.
Dual energy CT scan
This CT scan can detect urate crystals in a joint. However, it isn’t routinely used due to its expense.
Ultrasound
Ultrasounds can detect urate crystals in an affected joint. This diagnostic technique is more popular in Europe than in the United States.
Primary care physician
A primary care doctor is usually the doctor who treats gout. They can order uric acid blood tests, perform joint aspirations, and prescribe medications to treat the disease.
Rheumatologist
A rheumatologist is a physician with special training in treating diseases of the joints and connective tissues. A rheumatologist can provide more specialized care if your gout is especially severe or involves joint damage.
Changing your diet and some lifestyle habits can help protect you against future gout attacks. Here are some tips to try:
- Stay hydrated: Drink plenty of water and other fluids that are unsweetened or very low in sugar.
- Avoid alcohol: Alcohol should be limited or avoided if possible. Recent research shows that beer may increase your risks of a gout attack.
- Limit intake of meat: Eating too much meat, including fish and poultry, can raise your uric acid levels and lead to a gout attack.
- Maintain a healthy body weight: Getting regular exercise and sticking to a healthy diet will help you maintain a healthy body weight and decrease your risk of a gout attack.