What tests for gout should be taken?

What tests to take with gout ?. This issue will be considered by us in the article.

Such articular pathology as gout has long been known to mankind and used to be called the “disease of the kings", since only stately people who had access to fatty and dense foods suffered from this ailment.

Gout is currently a common disease and affects various social groups.

The essence of the disease is determined by the violation of protein metabolism in the human body, in connection with which uric acid is retained in it. Over time, it crystallizes, destroys the joints and subsequently becomes the cause of disorganization of the patient’s musculoskeletal system.

Causes

Modern medicine distinguishes two types of gout, which are the result of exposure to certain causative factors: the disease is primary and secondary.

Primary gout may appear in the body for the following reasons:

1. The patient produces too much uric acid, its excess affects the kidneys, which are not able to process it and remove it. The remainder in this case goes directly into the body, deposited in the soft tissues and joints.
2. The patient has impaired renal activity, the body cannot process the normal volume of urate (uric acid salts), which makes it impossible to remove them from the body.

Secondary gout is not an independent disease. These are the consequences of past pathologies (renal failure, psoriasis, etc.), that is, a kind of complication.

Bad habits and malnutrition

The reasons that contribute to the appearance of primary gout in a person are mainly the presence of bad habits and poor nutrition. For example, consuming a lot of fatty foods, it thereby causes an increase in the level of uric acid in the body, and the kidneys, despite the normal functioning, cannot process it. And bad habits, in principle, reduce the functioning of all human organs, including the kidneys. That is why, even if urates are contained in normal amounts, they accumulate and are deposited in the body.

Symptoms

Often the first sign of gout is an unpleasant sensation in the finger. Such pain lasts several minutes and passes. These symptoms do not need to be ignored, otherwise after a while everything will happen again, but the pain will intensify. Such a disease goes through several stages.

1. The initial stage is characterized by regular pain in the toe. They are usually accompanied by joint swelling, redness and fever. Moreover, at this stage, attacks appear at night and periodically last from two to eight days. The disease remains even after the cessation of pain.
2. The next stage is defined as subacute, in which the finger does not hurt so much. But at the same time there is a maximum swelling of the joints, inflammation increases.
3. The stage of rheumatoid gout passes already with joint pain in the hands, they can subside from time to time.
4. Very severe pain, along with a significant process of inflammation, as well as an increase in temperature are characteristic of the pseudo-phlegm stage, similar to monoarthritis.
5. The subsequent stage resembles the symptoms of polyarthritis. There is no specific area of ​​pain manifestation, the skin turns red, the joints swell. When pain in the extremities is not felt, this is a low-symptom stage. That is why a doctor is not often consulted.
6. Pain sensation in the tendons, impaired mobility of the limbs and their hardening are symptoms of the arthritic form. In this case, the muscles begin to atrophy, since the limbs are motionless, and also because of the excessive content of salts, bone crunch is noted.

What tests for gout should be taken?

Since gout can be both an independent disease and a complication after diseases suffered by a patient, treatment of such a pathology can be prescribed only after a diagnosis. With gout, the tests are supposed to be complex, since they are able to determine the stage, and symptoms of the disease, and the cause of its occurrence. These diagnostic methods include:

• Analysis of urine;
• blood chemistry;
• synovial fluid puncture;
• general blood analysis;
• biopsy;
• X-ray examination.

Blood chemistry

This analysis for gout should be taken in the morning. For this purpose, 5-10 milliliters of blood are taken from the cubital vein.

Thanks to biochemical analysis, you can see the volume of urea. Its permissible norm (limit) is 8.7 mmol per liter. Because of gout, such an amount increases and subsequently causes impaired renal function, the development of their insufficiency.

The creatinine norm in a blood test for gout (that is, the substance that forms when metabolic protein processes occur) is 115 mmol per liter. Renal pathology caused by gout reduces the amount of this component.

Since the pathological conditions of some organs may be noted with gout, this type of analysis allows you to determine the level of bilirubin, residual nitrogen, lipids, glucose, calcium and lipoproteins.

Analysis of urine

A very important role belongs to gout urine analysis. It helps to determine or clarify the diagnosis, and if there is a possibility of gout, then monitor the process and make adjustments to treatment methods. Such a diagnosis is very important, as it can determine a disease that occurs without other signs and with an inaccurate clinical picture.

For diagnosis, the following urine parameters are examined: transparency, color, reaction, and relative density.

Biochemical analysis of gout on the legs reflects the level of uric acid in the human body. The color of urine due to the high content of urates in gout is mainly brown or dirty orange (normally should be light yellow).

The proportion of urine in a healthy person ranges from 1010 to 1022 grams per liter. Renal failure, this indicator reduces.

The pH level has a normal value of 5.5-7.0. With impaired renal activity in the late stage of gout, an increase in alkali occurs more than seven.

Stagnation of urine causes the formation of nitrin in the detrusor (absent normally). The normal concentration of leukocytes in the analysis of urine in the field of view is from 0 to 3. If this number is increased, we can talk about the inflammatory process and the appearance of stones in the ureter.

Synovial fluid puncture

For gout, tests often include examining synovial fluid, which is similar in composition to blood plasma, but also contains hyaluronic acid. The study is carried out by puncture of the articular cavity, without analgesia (due to novocaine, there is a negative effect on chromatin, which is contained in the cell nucleus).

First of all, the diagnosis of pathology helps to determine the crystals of sodium urate. Also, the contents of the joint bag are checked for transparency, color, viscosity, density, the presence of mucinous clots.

The norm indicators are as follows: lymphocytes - 42.6%, synoviocytes - 37, histiocytes - 12.5, monocytes - 3.2, neutrophils - 2.0. In addition, this fluid contains waste particles of joint tissues. Cholesterol should be with a value of 3.8 ± 0.4 mmol per liter. And the pH is normal - from 7.3 to 7.6. Due to the condition caused by gout, these indicators undergo changes in the analysis.

Inflammation is determined due to the presence of phagocytes, a decrease in lymphocytes (from 0 to 8%), an increase in neutrophils (from 50 to 93%). The synovial fluid itself may become cloudy, acquire a green-yellow color. What analysis for gout can be passed yet?

General blood analysis

With an exacerbation of the disease, a general blood test is also prescribed (it may not determine changes at the initial stage). At this time, the number of new myelocytes and mature neutrophils increases with a shift in the leukocyte formula to the left. The process of inflammation also increases the erythrocyte sedimentation rate.

With an exacerbation of the disease, the number of lymphocytes that form and regulate the immune status decreases.

Other changes are characteristic only for concomitant renal damage with secondary gout or its severe form against the background of serious pathologies of the hematopoietic system.

Decipher any blood test with this diagnosis should only be a specialist.

Before a blood test, heavy physical exertion is prohibited (it does not matter if it is sports training or work), you can not drink coffee, tea and alcohol, take drugs and smoke. The purity of the diagnosis is negatively affected by stress.

Blood should be taken on an empty stomach or at least eight hours after a meal - the day before the study, it should be milk and vegetable. More precise recommendations about what tests are needed for gout will be provided by the attending physician.

X-ray examination

Checking the condition of the joints of the hands and feet can also be done with the help of an X-ray examination, which serves both for setting and for clarifying the diagnosis of a chronic disease. An x-ray allows you to see the destroyed places on the bones that suffered from pathology, and establish the state of tofus. Such a generalized term is called the foci of pathological seals of the subcutaneous tissue.

Thanks to this study, with gout on the legs, including the big toe, it is possible to determine the degree of cartilage and bone damage. With x-rays of the hands, tofuses are visible if gout is in the chronic phase.

Among other things, according to the indicators of analysis for gout, you can determine the period of limitation of the inflammation process.

Biopsy

This method is based on the removal of deposits of uric acid crystals. Thanks to its use, it is possible to accurately determine the type of disease, including gout.

False indicators

What tests you need to pass with gout, you already know. But if the patient ignores the rules of preparation for their delivery, they will show an increase in the content of uric acid in the body. That is, the wrong diagnosis can be made and, accordingly, the wrong treatment can be carried out. When the patient began to be treated on his own and take drugs that reduce the degree of urate in his body, the content of this substance when passing the test will be lower than what is actually available.

To obtain these test indicators for determining gout, you must adhere to the following recommendations:

1. You can’t eat anything eight hours before a biochemical or general blood test.
2. Analyzes are not allowed to be taken during treatment. This must be done either before its appointment, or after.
3. It is necessary to completely abandon the use of alcohol, any loads, reduce the amount of tea, coffee, and legumes taken.
4. A few days before the proposed study, you need to adhere to a diet and include lactic acid products and plant foods in your menu.

Despite the fact that it is impossible to cure chronic gout, the correct diagnosis will reduce pain, eliminate external symptoms of pathology and increase the period between exacerbations of the disease.

Knowing which tests to take with gout and how to do it correctly, you can avoid unwanted actions that can “blur” the picture when making a diagnosis.