Gout Diagnosis Tag

For the last 3 years, there has been interesting news about Dual Energy Computed Tomography for gout diagnosis.

Each year, roughly coinciding with annual rheumatologist meetings, we have seen reports of the amazing ability to see uric acid crystals in places previously hidden. This year is no exception.

Whilst the latest report shows that DECT is not the ultimate gout diagnostic tool for all situations, it does have a firm place in the rheumatologist’s toolkit.

I have reported on DECT For Gout Diagnosis earlier, and there are several more references, which you can find by entering DECT into the search box above. The latest report was presented at ACR Annual Scientific Meeting in November 2011, and the abstract follows.
Find out When Is DECT Best For Gout Diagnosis?

Now, strictly speaking, they don’t always remain hidden, as large deposits form tophi, that can break through the skin. But for our own peace of mind, and to help our doctors diagnosis and treatment, it really is a good idea to see what is happening in our joints.

Traditionally, the only way to test for the presence of uric acid crystals is to analyze fluid from the joints. Recently, there is hope that DECT might eventually replace this invasive procedure, but the huge expense of suitable scanning equipment puts this beyond the reach of most gout patients.

Advances in other medical imaging techniques leads to frequent reviews in professional journals. The most recent[1] of these concludes: Continue reading about Seeing Uric Acid Crystals

Uric Acid Diagnosis Vs Uric Acid Management

There is a significant difference in interpreting uric acid blood test results between confirmed and suspected gout cases. For a confirmed gout patient, any number above 7mg/dL (0.4 mmol/L) is a clear risk of a gout attack. Blood tests for confirmed gouties should be used as an aid to managing gout. They indicate whether urate lowering therapy is set at the right dosage. This is a fairly simple process, though it does rely on the doctor understanding the need to set the right target uric acid level, and it relies on the patient taking the medication daily as directed.

The problems arise when a gout diagnosis is doubtful, and uric acid blood test results are being used to help form a definite diagnosis. There are two fundamental problems with this approach, which I explain below. Gout diagnosis from blood tests is possible, but needs a clear understanding of the gout process, preferably bolstered by more tests on a weekly basis.

We know that uric acid crystals can form in joints at normal temperatures with a uric acid concentration of slightly under 7mg/dL ^[1]. For confirmed gout patients, it is almost certain that uric acid will form crystals at that level. For unconfirmed gout patients, there is a strong probability that it will cause a gout attack, but this is not certain.

Uric Acid Blood Test Reporting Problem

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