How gout is diagnosed | Gout Resource

A hot joint is not self-diagnosed

Gout is an inflammatory arthritis. Urate crystals can form in and around a joint, and the joint becomes inflamed. That is the condition NIAMS describes. Knowing the definition is not the same as knowing that this joint, tonight, is gout.

Plenty of painful joints are not gout. A guess from a sore toe, a photograph, or a page that matches your night does not settle it. If this is the first time, do not close the question because the story sounds familiar. Already having gout does not make the next hot joint automatically gout either.

Infection can look the same

A joint infection can look like a gout flare at the start: hot, swollen, and painful. Infection needs a person, not a comparison with last time. Other joint problems can look similar too. This page will not try to list them, and it will not give you a way to rule them out at home.

Fever, being unable to bear weight, or an episode that does not feel like your usual flares is a reason to get care now. It is not a detail to add to a diary and check in the morning.

What clinicians use

NIAMS and the Arthritis Foundation describe the tools. Clinicians use the story and the exam. They sometimes take a sample of fluid from the joint and look for crystals. Seeing those crystals is how gout is confirmed when a sample is taken. A sample is not always taken. Imaging is sometimes part of the workup. None of that is something you assemble yourself.

What you can usefully bring is concrete, not a conclusion: which joint, when it started, whether you have a fever, whether you can bear weight, and which medicines you already take. A list of questions, which is not advice, is on Questions to ask. What a flare feels like in ordinary life is on What gout is.

A blood urate test is not a yes-or-no during a flare

A blood test can measure urate. It does not interpret itself, and it is not a yes-or-no answer while a joint is inflamed. The level can be normal during a flare. That is a standard teaching point. This page does not print a number for what “normal” or “high” means, and a number on a webpage would not be your result.

High urate is not the same thing as gout. NIAMS notes that many people with high urate never develop gout. High urate can also be tied to kidney stones. A single blood test, during a flare or between flares, does not diagnose you and does not clear you.

Over a longer plan, blood tests are how a clinician follows urate-lowering medicine. That strategy is described, still without a target number, on Staying well and Medicines, by name.

This page will not hand you a checklist

There is no score here. There is no list of features that adds up to “you have gout.” Common places, including the big toe, are not a map of where gout is allowed to occur, and a joint in a common place is not proof.

Illustration of a standing figure with highlighted dots at the big toes, feet, ankles, knees, wrists, hands and elbows — Highlighted: big toes, feet, ankles, knees, wrists, fingers and elbows. The big toe is the classic site. The list is not complete, and a picture of where flares often show up cannot tell you what a particular joint has.

Do

Get care for fever, inability to bear weight, or a joint that is unlike your usual flares.
Tell the clinician the story, including medicines you already take.
Let that person decide whether fluid, a blood test, or imaging belongs in the visit.

Don’t

Diagnose yourself from a description, a photo, or a checklist.
Treat a blood urate result during a flare as a yes or a no.
Decide a hot joint is “just gout” because you have had gout before.

If a clinician has already confirmed gout and this episode is like your usual flares, what people commonly do next is on During a flare. That page still does not choose a medicine for you.

Calcium pyrophosphate deposition (CPPD), once called pseudogout, is the main crystal look-alike. How the two are told apart is on Pseudogout and gout.

Clinical claims on this page follow the sources.