Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Soft Tissue Case 4 Diagnosis

Gout


Diagnosis

The diagnosis can be made clinically in classic presentations. Definitive diagnosis requires arthrocentesis to confirm intracellular negatively birefringent crystals. Sometimes arthocentesis is required to rule out septic arthritis. X rays will be normal in early gout. They may be useful if rheumatooid arthritis is a consideration.

Serum uric acid levels are not useful for ED management. A normal serum uric acid does not rule out gout and, conversely, an elevated serum uric acid level does not diagnose gout.