Monosodium Urate; Image by euthman via FlickrFinding monosodium urate (MSU) in the synovial fluid from the affected joints of patients suspected of Gout is diagnostic of the disease. The new guideline suggests 7 variables, basing on which patients can be further tested to conform gout.
 clipped from www.medscape.comJuly 22, 2010 — A diagnostic rule involving 7 clinical variables is useful in helping to determine which patients are at high risk for gout and should undergo further testing with joint fluid aspiration to test for the presence of monosodium urate (MSU) crystals. The 7 variables, which the researchers describe as "easily ascertainable in primary care," include male sex, previous patient-reported arthritis attack, onset within 1 day, joint redness, involvement of the first metatarsophalangeal joint (MTP1), hypertension or 1 or more cardiovascular diseases, and serum uric acid level of more than 5.88 mg/dL. When the diagnostic rule was used (score ranging from 0 - 13), a score of 4 or less ruled out gout in almost 100% of patients. According to the researchers, in these patients, a differential diagnosis of rheumatoid arthritis, pseudogout, psoriatic arthritis, and reactive arthritis vs gout should be considered.
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