The list of medical tests mentioned in various sources as used in the diagnosis of Gout includes:
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Aspiration of synovial fluid (arthrocentesis) or of tophaceous material reveals needlelike intracellular crystals of sodium urate. Although hyperuricemia isn’t specifically diagnostic of gout, serum uric acid is above normal. Urinary uric acid is usually higher in secondary gout than in primary gout. In acute attacks, erythrocyte sedimentation rate and white blood cell (WBC) count may be elevated, and WBC count shifts to the left.
Initially, X-rays are normal. However, in chronic gout, X-rays show “punched out” erosions, sometimes with periosteal overgrowth. Outward displacement of the overhanging margin from the bone contour characterizes gout. X-rays rarely show tophi. (See Understanding pseudogout.)
Source: Professional Guide to Diseases (Eighth Edition), 2005
Patient history of painless joint deformity and underlying primary disease suggests neurogenic arthropathy. Physical examination may reveal bone fragmentation in advanced disease. X-rays confirm diagnosis and assess severity of joint damage. In the early stage of the disease, soft-tissue swelling or effusion may be the only overt effect; in the advanced stage, articular fracture, subluxation, erosion of articular cartilage, periosteal new bone formation, and excessive growth of marginal loose bodies (osteophytosis) or resorption may be seen. Computed tomography scan helps define the extent of disease.
Other diagnostic measures include:
❑ vertebral examination: narrowing of disk spaces, deterioration of vertebrae, and osteophyte formation, leading to ankylosis and deforming kyphoscoliosis
❑ synovial biopsy: bony fragments and bits of calcified cartilage.
Source: Professional Guide to Diseases (Eighth Edition), 2005
The presence of monosodium urate monohydrate crystals in synovial fluid taken from an inflamed joint or a tophus establishes the diagnosis. Aspiration of synovial fluid (arthrocentesis) or tophaceous material reveals needlelike intracellular crystals of sodium urate.
Although hyperuricemia isn’t specifically diagnostic of gout, the serum uric acid level is above normal. The urine uric acid level is usually higher in secondary gout than in primary gout.
Initially, X-ray examinations are normal. However, in chronic gout, X-rays show damage of the articular cartilage and subchondral bone. Outward displacement of the overhanging margin from the bone contour characterizes gout.
Source: Handbook of Diseases, 2003
A patient history of painless joint deformity and underlying primary disease suggests neurogenic arthropathy. The physical examination may reveal bone fragmentation in advanced disease. X-rays help confirm the diagnosis and help assess the severity of joint damage.
In the early stage of the disease, soft-tissue swelling or effusion may be the only overt effect; in the advanced stage, articular fracture, subluxation, erosion of articular cartilage, periosteal new bone formation, and excessive growth of marginal loose bodies (osteophytosis) or resorption may be seen.
Other diagnostic measures include:
❑ vertebral examination:narrowing of disk spaces, deterioration of vertebrae, and osteophyte formation, leading to ankylosis and deforming kyphoscoliosis ❑ synovial biopsy: bony fragments and bits of calcified cartilage.
Source: Handbook of Diseases, 2003
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