Gout

Okay. This raises the possibility that your joint pain is due to something other than gout. It's worth considering other possibilities (to be considered below). Certain facts make gout more or less likely. For example, gout is unlikely if you are a premenopausal woman. Gout tends to occur in women only when they are at least seven to ten years post-menopausal. It can occur in men of any age, though it is unusual in teenagers and is more common in older men or in people with a family history of gout.

Gout is likely if you have had repeated episodes of sudden first (big) toe pain and swelling that gets better without antibiotics over a few days, even if joint fluid has never been removed or examined.

Most experts agree that it is not always necessary to prove the diagnosis of gout by removing joint fluid; symptoms and examination alone may be so compelling that proof is unnecessary. On the other hand, you cannot diagnose gout from a blood test and often it is very helpful to prove the diagnosis by removing a bit of fluid.

Talk with your doctor about how certain the diagnosis of gout is.

Mimics of gout include certain infections and other types of arthritis including pseudogout, psoriatic arthritis, arthritis associated with inflammatory bowel disease, Reiter's syndrome and ankylosing spondylitis.

The next questions deal with the severity of your gout or problems that might be related to gout.

Is one or more of the following statements true for you?

• I've had gout in more than one joint at the same time.

• I have frequent attacks (4 or more times in a year).

• I have lumps under the skin (or have been told I have tophi).

• I have had one or more kidney stones.

• My gout has been hard to treat, taking more than a day or two to get under control and/or has required steroid pills.

Yes, one or more of those statements is true.

No, none of those statements are true.