Although it may be hard to distinguish gout from regular arthritis, doctors can usually distinguish gout by the symptoms– they determine a gout diagnosis because gout usually onsets on one joint at a time, whereas rheumatoid arthritis will usually attack many joints at the same time. Also, gout commonly occurs in the big toe first before symptoms occur in other places of the body.

The only sure way to diagnose gout is by taking a sample of the joint fluid and testing it for the uric acid crystals that have formed. This test is difficult to complete and should be performed by a specialist. When this test is performed the patient is put under local anesthesia and the doctor withdraws fluid from the joint using a needle. When the fluid is view under a microscope, the uric crystals will be visible.

Blood tests can also be done to determine the diagnosis. The blood tests will sample for high uric acid, full blood count, electrolytes, among other tests.

Sometimes x-rays are performed to determine a gout diagnosis– to see if the crystal deposits are visible, and also to look at the bone damage. Some doctors like to use x-rays to monitor the progress and effects of gout.