Understanding Gout: How to confirm Gouty Arthritis
Do you experience severe and sudden pain in the joints after drinking an alcoholic beverage or ingesting foods rich in Uric Acid? The gouty attack usually happens within four to six hours of taking in these types of foods. The examples of foods that increase the rich uric acid levels in your blood are:
- Certain vegetables such as asparagus, cauliflower, spinach, mushrooms, legumes, dried beans.
- Purine-rich foods such as meat extracts, beer, and alcohol
- Animal based protein including meat, seafood’s and poultry – meat products should be taken in moderation. Avoid consuming more than 150 milligrams of purine rich foods per 100 grams of meat.
What is Gout?
Gout is an inflammatory disorder which is caused by excessive deposition of MSU or monosodium urate crystals. The MSU’s are commonly deposited in the:
- Subcutaneous tissue
- And even in the aortic and mitral valves.
The main cause of gout is hyperuricemia or too much uric acid levels in the body. This normally happens when the human body does not produce uricase, an enzyme that metabolizes uric acid. So, the Uric acid is accumulated in the body. But did you know that only 70 to 80% of patients with gout have hyperuricemia?
Risk Factors for Gout
There are several typical risk factors for the development of gout, these are:
How to diagnose and confirm?
Your doctor may request the following laboratory tests to aid him or her in the diagnosis of gout and other potential co-morbid condition. In case, one of these tests is requested, you would know what is it for and why it is needed?
Patients with gout have initial presentation of impaired renal function and hypertension. Thus, tests that examine the cardiovascular and renal systems are very important. The baseline laboratory tests in diagnosis of gout are complete blood count, serum creatinine, blood urea nitrogen and serum uric acid. Although, depending on the severity of your condition, the following tests are also requested:
- Lipid Profile
- Liver Enzyme such as SGPT/SGOT
- Urine Uric Acid
- Synovial Fluid Analysis
- Fine Needle Aspiration for MSU Crystals
The Lipid profile is an independent predictor for gouty attacks. The serum lipid profile most commonly ordered for patients with gout. Studies have shown that, serum LDL cholesterol, total cholesterol, triglycerides, ration of apolipoprotein-B to AI, and apolipoprotein-B levels are significantly associated with the serum uric acid levels.
The BUN Creatinine ratio is requested to determine the condition of your kidney. If you have a creatinine clearance of 50 ml per minute, your doctor may give uricosuric drugs or the medications that help decrease the serum uric acid.
The CBC blood test is used to determine the levels of creatinine and uric acid in the blood.
The Erythrocyte Sedimentation Rate is commonly requested for patients with gout. It helps determine the level of the inflammation in your body. The limitations of this test are that it does not tell why there is an inflammation in the body. More so, it can also be elevated with other disease conditions. So, further tests are requested to confirm the diagnosis.
Urinalysis is a baseline test used to detect gout. Since the excess fluids and toxins are removed from the body in the form of urine. Requesting for urinalysis will provide an important health clue to detect the presence of gout, diabetes, and other metabolic diseases such as kidney disease.
Your doctor may also request liver enzymes to determine if your liver is working well particularly if he plans to gives you medication to lessen the severity of gouty attacks.
Urine Uric Acid
The urine uric acid is requested to know whether you are hyperproducers or not. More than 800 mg of Uric Acid in 24 hour urine collection are considered hyper-producers. They are also at risk of developing a kidney stone formation.
Synovial Fluid Analysis
People with an elevated WBC (white blood count) of 2000 to 60,000/uL are at risk of having gout.
Fine Needle Aspiration for MSU Crystal
This is the Gold Standard or confirmatory test in the diagnosis of gout. When the results show a negatively bifringent and needle shape MSU crystals upon polarized microscopy, it will confirm the diagnosis of gout.