Gout, known in Spanish as gota, is a painful form of inflammatory arthritis. It develops when high levels of uric acid in the blood form sharp crystals in and around the joints. A formal diagnosis from a healthcare provider is the first step toward managing the condition. This allows for a treatment plan to relieve pain from attacks and reduce future episodes.
Initial Signs and Symptoms
The most recognizable sign of gout is a sudden, severe attack of joint pain, or dolor articular intenso y repentino. This pain often begins abruptly, sometimes waking a person from sleep. While it can occur in various joints, it most commonly affects the big toe (dedo gordo del pie). Attacks can also target the ankles (tobillos), knees (rodillas), elbows, or wrists (muñecas).
Accompanying the pain are signs of inflamación y enrojecimiento (inflammation and redness). The joint will swell, and the overlying skin may appear red or purplish. This area becomes sensitive and warm to the touch, a symptom described as calor y sensibilidad. Even the slight pressure of a bedsheet can be painful during a flare. These symptoms reach their peak intensity within the first 12 to 24 hours.
The Doctor’s Evaluation
When visiting a doctor (médico) for suspected gout, the process begins with a review of your historial médico (medical history). A general practitioner or a specialist, known as a reumatólogo, will ask questions to understand your symptoms. Expect to discuss how often the pain occurs, how long it lasts, and which joints are affected.
Your doctor will also inquire about your lifestyle and family history. Questions about your dieta (diet) are common, as foods high in purines like red meat and seafood can raise uric acid levels. Alcohol, particularly beer, and drinks with high-fructose corn syrup are also risk factors. The physician will ask if family members have gout, as genetic factors can play a part.
Following the discussion, the doctor will perform a examen físico (physical exam). The clinician will inspect the affected joint for signs of inflammation. They will also assess the joint’s range of motion, which is often limited during a gout attack. This examination helps confirm the physical signs and rule out other causes, such as an infection.
Tests to Confirm Gout
While a medical history and physical exam provide clues, specific tests are needed for a confirmed diagnosis. The primary tool is a joint fluid test, or análisis del líquido sinovial. This procedure, called arthrocentesis (artrocentesis), involves using a needle to withdraw a small sample of fluid from the inflamed joint. The area is numbed, and the procedure is quick.
The collected fluid is examined under a polarized light microscope. A diagnosis of gout is made if the technician identifies needle-shaped monosodium urate crystals (cristales de urato). The presence of these crystals distinguishes gout from other forms of arthritis like pseudogout.
A doctor will also order a blood test (análisis de sangre) to measure the level of uric acid (ácido úrico) in your blood. High levels of uric acid, or hyperuricemia, are associated with gout. However, this test is not conclusive, as some people have high uric acid levels but never develop gout, while others have normal levels during an attack.
A physician may also use imaging tests (pruebas de imagen). Standard X-rays (rayos X) are not useful for diagnosing an early attack but can help rule out other joint problems. They can also identify joint damage in cases of chronic gout.
Advanced imaging like an ultrasound (ecografía or ultrasonido) can visualize urate crystal deposits and soft-tissue masses of crystals called tophi. A dual-energy CT scan, or Tomografía computarizada de doble energía (DECT), is a non-invasive test. It uses two X-ray energies to detect and color-code urate deposits.