Medical history and physical examination for gout

A medical history and a physical examination are often used to diagnose gout.

During the medical history, your health professional will typically ask about any:

  • History of gout in your immediate family.
  • History of sudden attacks of arthritis affecting one joint, especially the big toe, foot, ankle, knee, wrist, or finger.
  • History of wrist or ankle sprains or tendonitis without having an injury or your symptoms go away on their own in about a week.
  • Recent injury or surgery.
  • Recent infections of the skin, kidney, bladder, or lung.
  • Alcohol use.
  • Exposure to lead.
  • Recent diets.
  • Medical conditions, including high blood pressure, high triglyceride levels, heart disease, kidney disease, and diabetes.
  • Use of certain medications, especially diuretics and aspirin.

During a physical examination, your health professional will:

  • Take your temperature. Fever may accompany gout attacks.
  • Examine the skin over the painful joint to see whether it is warm, tender, red, or peeling.
  • Check the skin over the affected joint for cuts that may be a source of infection.
  • Feel the joint to assess pain.
  • Check the range of motion of the affected joint.
  • Examine your hands, elbows, feet, ankles, knees, and earlobes for gritty, chalklike clumps of uric acid crystals called tophi.

If your medical history and physical examination clearly suggest that you have gout, further testing may be postponed until treatment relieves pain and swelling or until subsequent attacks occur.

If the diagnosis remains unclear after the history and physical examination, your health professional may order a blood test to measure the level of uric acid in your blood and a joint fluid aspiration test to examine joint fluid for uric acid crystals.

Last Updated: July 11, 2008

Author: Shannon Erstad, MBA/MPH

Medical Review: Anne C. Poinier, MD - Internal Medicine & Stanford M. Shoor, MD - Rheumatology

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