An evaluation of gout begins with a history and physical examination.

Physical findings in someone with gout may include:

• Joint pain
• Joint redness
• Joint swelling
• Joint warmth
• Fever
• Rash:
• Erythema marginatum may be present
• Skin nodules

Tests are required to make the diagnosis of gout.

Tests that may be used to evaluate gout include:

• Serum uric acid level
• Lyme disease assay
• HLA B27 assay
• Blood anti-DNAase B
• Blood streptozyme
• Blood ASO titers
• Complete blood count
• Erythrocyte sedimentation rate: ESR may be elevated
• Throat culture or rapid strep screen:
• Detects streptococcus bacteria
• Echocardiogram
• Arthrocentesis:
• Can confirm the diagnosis of gout; microscopic analysis of this fluid should reveal the uric acid crystals that are characteristic for gout.
• A synovial membrane or subcutaneous nodule biopsy can also be used to confirm gout.
• Arthroscopy
• Arthrogram:
• Less commonly used
• MRI scan of joint
• Joint x-rays