Gout is a disorder of joints resulting from the accumulation of uric acid crystals in the synovial fluid. It can affect the joints of big toe, feet, ankles, knees, wrists and hands and lead to inflammation, redness, stiffness and tenderness of joints. If the condition becomes chronic and severe, it can cause deformity and disability of joints. Hence, early diagnosis of gout is necessary to decide the treatment plan.

Self-assessment is very important for the diagnosis of gout. You can assess the warning signs and symptoms of gout which may help your doctor for accurate diagnosis. If you experience sudden intense pain in one joint, generally big toe as well as joints of knees, ankles, feet, wrists and hands and swollen red skin, it may indicate onset of gout. The affected joint may be swollen and warm to touch and the skin around the joints is red or purple. If you find these symptoms, you should consult your doctor for confirmation of the diagnosis.

As the symptoms of gout may resemble other medical conditions such as pseudogout, rheumatoid arthritis, psoriatic arthritis and infection, proper diagnosis of gout is essential for appropriate treatment. Diagnosis procedure starts with physical examination and medical history and family history of the patient. If you have family history of gout, then you are more prone to this disease. Red shiny skin above the affected area and presence of tophi below the skin are indicative of gout. For accurate diagnosis, your doctor may prescribe some laboratory and imaging tests.

As gout is mainly caused by elevated levels of uric acid in the blood, determination of serum uric acid level is the significant blood test for diagnosis. However, it is possible that person with high uric acid levels may not have gout or person with gout may not have elevated levels of uric acid.

Analysis of synovial fluid is the most reliable test for the diagnosis of gout. Joint fluid is obtained by arthrocentesis (joint aspiration) which is performed under local anesthesia. This fluid is analyzed for the presence of uric acid crystals and infection. Shiny, needle-like urate crystals indicate the presence of gouty arthritis. If these urate crystals are found from bursitis fluid and in the material aspirated from tophi, they indicate gout. If the crystals are not found, the diagnosis cannot be made certainly.

In addition to laboratory investigations, the imaging test like x-ray is helpful to monitor the effects of chronic gout on joints.   Common x-ray findings of gouty arthritis are tophi crystal deposits and joint damage.