Gout tests are essential if unstable symptoms such as soreness and swelling of the limb joints are detected. This will help in timely treatment and prevent dangerous complications affecting the health of the patient.
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What is a diagnostic test for gout?
Gout (gout) is also known as gout disease in the concept of Oriental medicine. This is a disease that occurs due to a disorder of purine metabolism in the body, increases the concentration of uric acid in the blood, at the same time the ability to excrete uric acid is impaired and facilitate the formation of urate crystals to be deposited in the body. musculoskeletal joints and many other places in the body.
The most common symptoms of gout are severe, lingering pain, painful swelling and redness in the affected joint, inflammation and stiffness, and pain often occurs at night. affects the quality of sleep, the patient easily gets tired, stresses and reduces the quality of life, more importantly, it causes complications affecting the ability to move and walk.
Therefore, it is necessary to perform gout test as soon as possible when detecting unusual symptoms of pain in the joints. Basically, the gout test is a test that checks the uric acid index in the blood and urine, and based on the test results it will give an accurate diagnosis.
In addition, in some special cases, the doctor suspects that the patient is suffering from gout in an acute phase but the test result is not high uric acid index may need to perform some other tests to check the degree of progression as well as complications of the disease.
Symptoms suggestive of gout
The earlier you get gout testing, the easier and faster treatment for gout is. Therefore, it is very important to know the basic symptoms of recognition and get tested early.
Symptoms of acute gout
People with acute gout usually have the following basic symptoms:
- The first pain usually starts in the big toe, then the aches usually spread to the other toes and most limbs.
- Severe pain, even unbearable, burning sensation, discomfort and poor appetite. Most of the pains come on suddenly at night.
- After the pain is over, the affected joint is often itchy and flaky, and the areas around the joint are painful, red and purple, like an infection.
- Accompanying it is a high fever, shortness of breath, cold hands and feet and limited movement.
Symptoms of chronic gout
Chronic gout is gout in the acute phase, but there is no treatment or optimal treatment. Some typical symptoms at this stage are:
- Pain that appears less than a few months or a year does not appear once.
- However, if pain occurs in succession, the pain is characterized by rapid disappearance but the severity of pain is very severe.
- Causing serious damage to joints such as big toe, hand joint, foot, knee joint, elbow joint, ankle joint … affecting the motor function of the patient.
- Tophi appear next to the affected joint area or in the ear rim. This is also a sign that the patient’s condition is at an extremely dangerous level.
The basic types of gout tests available today
To be sure that the patient has gout or not, doctors will usually order four basic tests:
Blood uric acid blood chemistry (AU) test
Most suspicions of gout will be indicated for an AU test. When performing this test, the patient is also testing the concentration of uric acid in the blood. Depending on the test results of each patient, your doctor will accurately diagnose whether you have gout or not.
If a normal result is given at the first test, ie no gout, it may be ordered to perform several more times to ensure the most accurate results. Because according to statistics, up to 40% of cases of people with acute gout have normal AU index when performing the first test.
Uric acid uric acid test 24 hours
Often, tests for AU through urine will be indicated in cases where doctors confirm that the patient has gout at a high rate through clinical examination methods.
Performing this test will help the doctor evaluate the rate of uric acid excretion through the urinary organs, thereby diagnosing the cause of high uric acid levels in the blood due to poor excretion or increased body proliferation. uric acid, thereby giving the most suitable treatment.
Joint fluid test
For people who have had symptoms of gout for a long time, this can cause lasting pain. Therefore, performing a joint fluid test will be indicated in these cases.
Joint fluid is sucked out and tested for analysis, if detecting the presence of urate crystals, it will definitely be gout, but if not, it can be common arthritis or other diseases. for appropriate treatment.
Kidney function tests
When gout is in a severe stage, urate crystals are not only deposited in the joints but also exist in many different locations such as liver, heart, brain and kidney … Therefore, most people with gout are will accompany other diseases including kidney diseases such as kidney failure, kidney stones, glomerulonephritis … extremely dangerous.
At this time, to be able to assess the level and progression of gout, the patient may be ordered to perform kidney function tests to get the most accurate results. Some common kidney function tests such as blood urea test, serum creatinine test, kidney ultrasound, urinary cytology test …
In addition to the testing methods to diagnose gout above, depending on the complexity of each case, the patient will be assigned to perform imaging diagnostics together to ensure the final diagnosis. the most exactly.
May be mentioned as:
- Joint x-ray
- Joint CT scan
Guide to gout diagnostic testing procedure
Depending on the patient sample, the sampling procedure will be different. Whereby:
For blood samples
Diagnostic tests for gout using a blood sample will be performed according to the following steps:
- Step 1: Disinfect the location about to take blood with medical alcohol
- Step 2: Tie the garo string to the hand area to maintain the pressure, limit the amount of blood circulating through the veins, helping the location of the blood draw to swell to easily puncture the needle and take blood.
- Step 3: Insert the needle into the correct venous position and withdraw a sufficient blood tube. Note that the needle to take blood should be a small needle.
- Step 4: Remove the garo wire to allow blood to circulate normally.
- Step 5: Pull out the heart needle and sell the gauze bandage to the spot where the blood was taken to stop the bleeding.
- Step 6: Put the blood sample collected in a syringe or in a sterile vacuum sterilized glass bottle with the patient’s full name to preserve and wait for laboratory analysis.
- Note that the blood contained in the syringe must contain anticoagulants to prevent the clotting process from affecting the test results.
For urine samples
Depending on the characteristics of each patient, the doctor will request a 24-hour urine collection or just one collection.
The process of taking urine 1 time
- Step 1: The patient must clean the genitals and urinate. The first and last urine are for separate potty, the middle urine part is on another potty.
- Step 2: Nurses will proceed to take about 20ml of middle urine into a test tube and cover it tightly.
- Step 3: Bring the patient sample and test paper to the laboratory.
- Step 4: Handle and clean all sampling equipment in accordance with regulations.
24-hour urine collection procedure
- To get urine within 24 hours, it is imperative to use preservative chemicals: 1 drop of formol or phenol solution corresponding to 30 ml of urine, 1ml of thymol 1% in alcohol corresponds to 100ml of urine. Thereafter, gradually increase gradually with the patient’s urine output.
- To obtain a suitable urine sample, the patient will be told to collect urine throughout the day, including urine during defecation, after having finished, cover the potty and put it in a cool place.
- At the time of the last urination, a set time will be set. After finishing, the nurse will measure and record the amount of urine for the day on the monitoring sheet.
- Proceed to take the required urine sample into a test tube and bring it to the laboratory.
What do gout diagnostic tests mean?
For a normal person, the concentration of uric acid in the blood will fluctuate in the following levels:
- Men: 210 – 420 μmol / L.
- Females: 150 – 350 μmol / L.
For normal people, uric acid concentration in urine ranges from 2.2 to 5.5 nmol / L / 24h.
If this level of uric acid is found to be higher than normal, it means that your body is producing a lot of uric acid or impaired kidney function that prevents uric acid from being eliminated from the body.
The results of blood and urine tests will be the basis for the doctor to accurately diagnose whether you are suffering from gout or not.
Normally, when the uric acid level is only high, but not causing any clinical symptoms, it is not called gout, but just called “Hyperuricemia”. However, it is not until uric acid rises and remains at this level for a long time and causes acute nocturnal gout attacks that gout is exactly.
Some note when performing diagnostic tests for gout
Before conducting the gout test, patients need to pay attention to the following issues:
- Do not use antibiotics, diuretics such as Aspirin, vitamin C, Colchicine, Allopurinol … for 3-4 days before the test to avoid changes in uric acid index.
- For 4 – 8 hours before the test, the patient should not eat anything.
- Absolutely do not use drugs or supplements without the permission of your doctor.
- Avoid eating or drinking a variety of starchy foods, high in protein, fat, candies …
- Drink plenty of water every day and take time to rest, keep the spirit always at its best.
Where is the test for gout?
Currently, across the country, there are many medical facilities and hospitals that carry out accurate gout testing and diagnosis. Patients can refer to some of the following addresses to be able to more easily choose the most reputable and suitable place.
- 115 People’s Hospital
- Ho Chi Minh City University of Medicine and Pharmacy Hospital
- Hanoi Medical University Hospital
- Ho Chi Minh City Orthopedics Hospital
- Bach Mai Hospital
In summary, the earlier implementation of gout diagnostic tests will help the treatment process easier and faster, avoiding dangerous complications. For the cases that the test results show that there is an increase in uric acid but there are no clinical signs of gout, the patient should visit the musculoskeletal specialist for appropriate treatment.