How Is Gout Diagnosed?
Gout may be difficult for doctors to diagnose because the symptoms may be vague, and they often mimic other conditions. Although most people with gout have hyperuricemia at some time during the course of their disease, it may not be present during an acute attack. In addition, having hyperuricemia alone does not mean that a person will get gout. In fact, most people with hyperuricemia do not develop the disease.
Tests
To confirm a diagnosis of gout, a doctor may insert a needle into an inflamed joint and draw a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for monosodium urate crystals under a microscope. Their absence, however, does not completely rule out the diagnosis. The doctor also may find it helpful to examine chalky, sodium urate deposits (tophi) around joints to diagnose gout. Gout attacks may mimic joint infections, and a doctor who suspects a joint infection may check for the presence of bacteria.
Future Attacks
Without treatment, an initial acute attack of gout will run its painful course within several days or a few weeks, by which time all outward evidence of the disease disappears.
The next acute attack? - 50% or more of gout sufferers will have a second attack — which may not occur for months or years. Subsequent attacks, however, are likely to be more frequent, more severe, and more destructive to joints and other tissue unless the problem is treated.
