Gout: Diagnosis and Treatment

Diagnosis

• A medical history and a physical examination can suggest the diagnosis. However, laboratory testing is required for a definitive diagnosis.
• Blood and urine tests usually show high levels of uric acid.
• A joint aspiration may be necessary. In this test, a small needle is placed into the affected joint, and some joint fluid is removed. This fluid is examined under a microscope to assess for crystals of uric acid or other signs of gout.
• In longstanding cases, X–rays of the joints may reveal abnormalities consistent with gout.

Treatment

• Prevention of flare–ups may include dietary changes (see Nutritional Considerations, below) and medications (e.g., allopurinol or probenicid).
• Flare–ups are most commonly treated with bed rest and nonsteroidal anti–inflammatory drugs (NSAIDs) (e.g., ibuprofen or indomethacin). Steroids may be used in cases of severe disease or in individuals who cannot take NSAIDs (e.g., patients with a history of stomach ulcers or kidney disease).
• Surgery is reserved for severe cases that cannot be treated with the above measures.