Gout

Diagnosis

Gout is usually diagnosed based on symptoms and the appearance of affected joints. Additional tests may include:

• Joint fluid test: Fluid is drawn from the joint with a needle to check for urate crystals under a microscope

• Blood test: Measures uric acid levels in the blood, though results may not always correspond with gout symptoms

• X-ray imaging: Helps rule out other causes of joint inflammation

• Ultrasound: Detects urate crystals in joints or in tophi

• Dual-energy computerized tomography (DECT): Uses multiple X-ray images to visualize urate crystals in joints

Treatment

Gout treatment focuses on two goals: relieving inflammation and pain during attacks, and preventing complications by lowering uric acid levels.

Medications for gout attacks

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Options include over-the-counter ibuprofen and naproxen, or prescription NSAIDs like indomethacin and celecoxib. Side effects may include stomach pain, bleeding, and ulcers

• Colchicine: Reduces gout pain and inflammation. Side effects may include nausea, vomiting, and diarrhea

• Corticosteroids: Such as prednisone, can be taken orally or injected into the joint. Side effects may include mood changes, elevated blood sugar, and high blood pressure

Medications to prevent gout complications

• Uric acid production blockers: Allopurinol and febuxostat reduce uric acid production. Side effects may include rash, liver function changes, and potential heart risks with febuxostat

• Uric acid excretion enhancers: Probenecid improves kidney removal of uric acid. Side effects may include rash, stomach pain, and kidney stones

Treatment choice depends on symptom frequency, severity, and other underlying health conditions. Regular monitoring and lifestyle adjustments can help prevent future gout attacks and joint damage.