Arthritis and Gout
How Is Gout Diagnosed?
Gout cannot be diagnosed simply from a blood test, because many people have elevated blood uric acid levels but do not have gout. Rather, gout is diagnosed from the fluid of an inflamed joint. The fluid is observed under a microscope for uric acid crystals.
Fluid is removed through a needle during a procedure called arthrocentesis. Extracting the fluid not only aids in diagnosing the condition, but it may also reduce pressure within the joint, thereby reducing pain.
If crystals are not found in the fluid, the diagnosis of gout cannot be made with certainty. Occasionally, crystals may not be seen the first time, but may be seen if additional fluid is removed during a subsequent attack.
Since gout can cause chronic joint pain and involve other joints, it is extremely important that an accurate diagnosis be made so your doctor can prescribe the appropriate treatment.
How Is Gout Treated?
There is no cure for gout, but it can be treated and controlled. Symptoms often are relieved within 24 hours after treatment has begun.
The type of treatment prescribed will depend on several factors, including the person's age, type of medications he or she is taking, overall health, medical history, and severity of gout attacks. Gout attacks are mainly treated with anti-inflammatory drugs. These include:
(nonsteroidal anti-inflammatory drugs), such as ibuprofen or naproxen, are generally prescribed to treat sudden and severe gout attacks. They usually reduce inflammation and pain within hours.
(also called steroids), may be prescribed for people who cannot take NSAIDs. Steroids also work by decreasing inflammation. Steroids can be injected into the affected joint or given as pills.
Colchicine is often used to treat gout and usually begins working within a few hours of taking it. This drug is used less often due to concerns about its side effects.
Long-term treatment of gout (to prevent attacks) involves medicine that lowers uric acid levels, such as Benemid, Uloric, or Zyloprim. Low doses of colchicine are also used to prevent attacks. These drugs are recommended for people who have had multiple attacks of gout, kidney stones due to uric acid, or tophi. The goal of lowering the blood uric acid is to slowly dissolve deposits of uric acid in the joint.