Gout Diagnosis

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Gout Diagnosis
Gout Diagnosis
Video: Gout Diagnosis
Video: Gout Diagnosis 2023, February
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Gout: diagnosis

Gout - formerly also called "niggle" - is one of the most common diseases of civilization in industrialized countries. In our part of the world, gout is the most common inflammatory joint disease at two to three percent. Men are affected significantly more often than women. The uric acid level increases with age and body weight. Gout attacks usually come without warning, often at night. Uric acid crystals usually cause an inflammatory, very painful swelling in a single joint. The doctor usually recognizes gout based on the typical symptoms at the beginning of a gout attack.

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  • Which laboratory tests are carried out?
  • Which imaging processes are used?
  • Whom can I ask?
  • How are the costs going to be covered?

Gout disease is considered likely if

  • At the beginning only one joint (usually the metatarsophalangeal joint) is affected,
  • the symptoms develop quickly, i.e. within hours,
  • the symptoms disappear within a week or two.

The diagnosis of gout is considered confirmed if at least one of the following points also applies:

  • Phagocytosed uric acid crystals detectable in the synovial fluid (gold standard),
  • Gout-typical changes on ultrasound,
  • Detection of uric acid deposits in dual-energy computed tomography (DECT).

Which laboratory tests are carried out?

In the time between two gout attacks, the affected joint is usually slightly swollen, and uric acid crystals can be detected in the synovial fluid. Gout often occurs together with obesity, diabetes mellitus, high blood lipid levels and high blood pressure. The patient is therefore also examined for these diseases. If necessary, it will be checked whether the kidney function is impaired. Screening for cardiovascular risk factors is also recommended because of the association with gout.

If it is suspected, the uric acid concentration in the blood is determined. In gout, the uric acid in the blood is increased (> 6.8 mg / dl), but can be normal during an acute gout attack. Inflammation levels (e.g. CRP) are usually high during an attack. Depending on the affected joint and if there is an effusion worth puncturing, the synovial fluid is examined microscopically for uric acid crystals.

Which imaging processes are used?

Gout diseases can only be recognized on x-rays when large accumulations of uric acid crystal deposits have formed near the joint or in the bones. These then appear, among other things, as punched out cavities (hole defects). In most cases, joint ultrasound allows the diagnosis to be made much earlier. In dual-energy computed tomography (DECT), uric acid crystals are shown in color and thus enable diagnosis at a glance.

Whom can I ask?

If you suspect gout or high uric acid levels, you can contact a general practitioner for diagnosis.

How are the costs going to be covered?

All necessary and appropriate diagnostic and therapeutic measures are taken over by the health insurance carriers. You can find more information under What does a hospital stay cost? Your resident doctor or outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (treatment contribution) (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract). For more information, see Visit a Doctor: Costs and Deductibles.

For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.

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