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Purpose: The purpose of this review paper is to present an overview of the clinical presentations, laboratory and radiological studies needed to make the diagnosis of gout.
Findings: Acute gout typically presents with a sudden and extreme joint pain most classically in the first metatarsophalangeal (MTP) joint (toe). Demonstrating the presence of monosodium urate (MSU) crystals in the joint fluid or tophus has been the gold standard for the diagnosis of gout. However, many physicians do not perform synovial fluid (SF) analysis.
In the absence of demonstrating the presence of MSU crystals in aspirated joint fluid or tophus clinical, radiological and laboratory criteria are helpful.
Conclusion: The presence of MSU crystals in SF or tophi remains the gold standard for the diagnosis of gout. In the absence of demonstrating the presence of MSU crystals, the clinical presentation, laboratory and imaging modalities are of utmost importance in making the diagnosis of gout.