To diagnose gout, the most effective test is performing a microscopic examination of synovial fluid. A needle is used to aspirate the synovial fluid from an inflamed joint. Using a polarized microscope, a medical professional will analyze the fluid. Presence of monosodium urate crystals is the medical standard for diagnosis of gout. This test differentiates gout from other disorders that cause joint inflammation, such as rheumatoid arthritis. 

 

Obtaining a blood specimen for a uric acid level is a tool used for monitoring gout. A high uric acid level does not necessarily mean a patient has or will ever develop gout. Many other disorders such as Lesch-Nyhan syndrome and metabolic syndrome also present with high levels of uric acid but for a patient already diagnosed with gout, uric acid levels can be monitored to prevent future flare-ups.     

 

Attacks of acute gout can be unpredictable. One patient may have a swollen big toe and never experience another attack while another patient may have repeated flare-ups causing pain, redness, and swelling in the wrists, knees, and heels. Immediate relief from the pain and discomfort may be required. Draining fluid from the inflamed joint can provide relief with minimal side effects.

 

For less painful attacks, nonsteriodal anti-inflammatory drugs may be administered. There are many over-the-counter options in the form of ibuprofen and naproxen as well as prescription options like indomethacin. If a patient is unable to take nonsteriodal anti-inflammatory drugs, colchicine is an alternative but has more side effects in the form of nausea, diarrhea, and vomiting. A low dose of colchicine after the episode of gout has resolved may prevent further attacks. The final line of attack against gout is corticosteroids which can be given in pill form or injected directly into the inflamed joint. Because of the numerous side effects, such as bone thinning and a decreased ability to fight infection, corticosteroids are generally reserved for patients unable use all other options.

 

Once an episode of gout has resolved, preventing further attacks is necessary. A doctor may prescribe a prescription that blocks the production of uric acid, such as allopurinol which is a xanthine oxidase inhibitor, or a prescription that improves the body’s ability to remove uric acid.

 

Gout was once known as the rich man’s disease because it was believed to be caused by eating rich foods. Research now shows that while a diet of rich foods and alcohol may not cause gout, it does play a role in causing a gout attack. A diet low in purines and alcohol, which lead to uric acid production, is recommended for people suffering from gout.