Tests and diagnosis

When to seek medical advice

If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage.

Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection.

Tests and diagnosis

Tests to help diagnose gout may include:

• Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint. When examined under the microscope, your joint fluid may reveal urate crystals.
• Blood test. Your doctor may recommend a blood test to measure the uric acid level in your blood. Blood test results can be misleading, though. Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don't have unusual levels of uric acid in their blood.

Complications

People with gout can develop more-severe conditions, such as:

• Recurrent gout. Some people may never experience gout signs and symptoms again. But others may experience gout several times each year. Medications may help prevent gout attacks in people with recurrent gout.
• Advanced gout. Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi (TOE-fi). Tophi usually aren't painful, but they can become swollen and tender during gout attacks.
• Kidney stones. Urate crystals may collect in the urinary tract of people with gout, causing kidney stones. Medications can help reduce the risk of kidney stones.

GOUT

Gout is a complex disorder that can affect anyone. Men are more likely to get gout than women are, but women become increasingly susceptible to gout after menopause.

Fortunately, gout is treatable, and there are ways to reduce the risk that gout will recur.

Risk factors

You're more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include:

• Lifestyle factors. Choices you make in your everyday life may increase your risk of gout. Excessive alcohol use — generally more than two drinks a day for men and more than one for women — increases the risk of gout.
• Medical conditions. Certain diseases and conditions make it more likely that you'll develop gout. These include untreated high blood pressure (hypertension) and chronic conditions, such as diabetes, high levels of fat and cholesterol in the blood (hyperlipidemia), and narrowing of the arteries (arteriosclerosis).
• Certain medications. The use of thiazide diuretics — commonly used to treat hypertension — and low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
• Family history of gout. If other members of your family have had gout, you're more likely to develop the disease.
• Age and sex. Gout occurs more often in men than it does in women, primarily because women tend to have lower uric acid levels than men do. After menopause, however, women's uric acid levels approach those of men. Men also are more likely to develop gout earlier — usually between the ages of 40 and 50 — whereas women generally develop signs and symptoms after menopause.