Symptom Checklist
While a gout diagnosis in patients with multiple acute attacks in classic locations may be obvious, the variability of the disease and its similarity to pseudogout, septic arthritis, and other conditions may make a diagnosis less clear in other cases.
While not constituting a diagnosis, the following is a quick reference list of typical and atypical gout signs and symptoms to consider:
Typical gout signs and symptoms
- Sudden onset of acute arthritis
- Multiple attacks over time
- Erythema over involved joint
- Pain and/or swelling of first MTP or tarsal joint
- First attack usually monoarticular
- Presence of tophus
- Hyperuricemia
- X-ray with asymmetric joint swelling and/or subcortical cysts without erosions
- Joint fluid with monosodium urate monohydrate microcrystals
- During attack, joint fluid culture without bacteria
- Fever
- Neutrophilia
Atypical gout signs and symptoms
- Involvement of knee, finger, elbow, wrist in first attack
- Involvement of joints in the sternum or clavicle, or the cervical spine
- Bursitis
- Polyarticular initial presentation
- Popliteal cyst formation
- Synovial fluid leakage
- Lower limb cellulitis or swelling
- Carpal tunnel syndrome
- Spinal cord or peripheral nerve compression
- Intradermal tophi
Dr. Brian Mandell recently delivered a presentation to primary care physicians addressing the clinical manifestations of gout. Watch and download Dr. Brian Mandell’s presentation. Watch Videos