Gout test: what’s involved?

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A gout test can include a physical exam, x-rays, blood tests, and a sample of synovial fluid. Results may not always be conclusive, and the tests can cause discomfort. X-rays are useful for advanced cases, while synovial fluid samples are the best option.

In a gout test, a pathologist will examine a sample from a patient to check uric acid levels. The doctor may also order x-rays of the patient’s toe to check for signs of gout-related injuries, and may also perform a physical exam. Test results are not always conclusive. The doctor may decide to treat the condition such as gout even if the test does not categorically determine that the patient has this joint condition.

The best gout test is a sample of synovial fluid. In this test, your doctor inserts a needle into your foot joint to collect a sample of fluid. The pathologist may check it for the telltale crystals of uric acid seen in the joints of gout patients. During a flare-up, however, it can be difficult to get fluid out of the tip, and so this test isn’t always possible. If the test would be too painful or the patient does not have enough fluids, the doctor may recommend an alternative gout test or suggest retesting in the future.

Another option is a blood test. Some patients with gout have high levels of uric acid in their blood. It is important to be aware that a higher level does not necessarily mean a patient has gout, as some medications can alter blood chemistry. Conversely, having a normal or low level does not mean gout is not present, as some patients who definitely have gout have normal blood levels. Therefore, this test can be useful, but not categorical.

X-rays are useful as a test for gout in patients with advanced disease. Chronic gout will lead to erosion of the structures within the joint and this can be clearly seen on X-rays. The doctor may recommend this option for a patient with a history of joint pain and signs of gout. No visible signs of damage may indicate that the patient’s case is mild or new, and therefore has not yet caused enough damage to be visible on X-rays.

Depending on the method, a gout test can cause discomfort and irritation. The synovial fluid sample can be very painful, as the foot joint is already tender and your doctor may need to probe with the needle to get a clean sample. The blood test should be relatively painless, as long as the technician has adequate training in taking blood samples. Radiographs should not be painful, although the patient may sometimes find it uncomfortable to stay still in the right position.

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