Gout

Gout is a form of crystal arthritis caused by monosodium urate (MSU) crystals that form when uric acid levels are high or when urine is too acidic to dissolve uric acid well. It often presents as sudden pain, swelling, warmth, and redness in a joint—commonly the big toe, ankle, knee, or mid-foot. Because gout symptoms overlap with infectionother arthritides, and injury, lab testing helps confirm the cause and uncover risks for future flares and kidney stones.

A proactive testing plan starts with serum uric acid and inflammation markers (ESR/CRP) and adds kidney function (creatinine/eGFR)urinalysis with urine pH, and—when appropriate—24-hour urine uric acid to assess overproduction vs. under-excretion and stone risk. Remember: a normal uric acid during a flare does not rule out gout, and the gold standard for diagnosis is synovial fluid crystal analysis (clinician-performed). These labs support screeningdiagnostic triage, and monitoring, but they do not replace a clinician’s exam, imaging, or urgent care for severe symptoms.

Signs, Symptoms & Related Situations

  • Joint findings: sudden severe pain, swelling, warmth, redness; tenderness to light touch; limited motion

  • Common sites: big toe (first MTP), mid-foot, ankle, knee; later, elbows, wrists, fingers

  • Between flares: tophi (firm, chalky nodules), lingering stiffness, limited range of motion

  • Stone/liver–kidney clues: flank pain, blood in urine, recurrent uric acid kidney stones; abnormal creatinine/eGFR

  • Metabolic context: central weight gain, high triglycerides, insulin resistance, high blood pressure

  • When to seek urgent care: fever with an acutely swollen joint, severe unrelenting pain, inability to bear weight, confusion, or signs of infection

All symptoms require evaluation by a qualified clinician.

Why These Tests Matter

What testing can do

  • Quantify uric acid and track trends associated with gout risk

  • Differentiate gout mimics by pairing uric acid with ESR/CRP, CBC, and (when indicated) rheumatoid markers

  • Assess stone risk and urate handling with urinalysis (pH) and 24-hour urine uric acid

  • Establish baselines for kidney and metabolic health that influence gout

What testing cannot do

  • A single serum uric acid result does not diagnose gout; levels may be normal during flares

  • Replace synovial fluid crystal analysis, which confirms MSU crystals

  • Provide treatment or dosing guidance; that belongs with your clinician

What These Tests Measure (at a glance)

  • Serum Uric Acid: measures urate in blood; helpful for risk and monitoring. Can be normal during an acute flare; trend over time is key.

  • ESR & CRP: inflammation markers that often rise during active arthritis; nonspecific but useful context.

  • CBC: white-cell count for inflammation/infection context; platelets can rise with inflammation.

  • Basic/Chemistry Panel (BMP/CMP): creatinine/eGFR (kidney function), electrolytesliver enzymes for overall health and safety context.

  • Urinalysis with Urine pH:** acidic urine increases uric acid stone risk; blood/protein may suggest stone passage or kidney stress.

  • 24-Hour Urine Uric Acid (± stone risk profile): estimates uric acid excretion to help distinguish overproduction vs. under-excretion and assess stone risk.

  • Rheumatologic Exclusions (as directed): rheumatoid factor (RF)anti-CCPANA if history suggests another arthritis.

  • Clinician-performed diagnostics: Synovial fluid crystal analysis (needle-shaped, negatively birefringent MSU crystals) confirms gout; joint ultrasound (double-contour sign) or DECT may support diagnosis.

Quick Build Guide

Clinical goal Start with Add if needed
Acute swollen joint (suspected gout) Serum uric acid • ESR/CRP • CBC Synovial fluid crystal analysis (clinical) • BMP/CMP
Baseline between flares Serum uric acid • BMP/CMP • Urinalysis (pH) Lipid panel • A1c/glucose for metabolic context
Recurrent flares or early onset Serum uric acid • BMP/CMP 24-hour urine uric acid (urate handling)
Kidney stone history Urinalysis (pH) • Serum uric acid 24-hour urine uric acid ± stone-risk profile
Uncertain diagnosis Serum uric acid • ESR/CRP • CBC RF/anti-CCP/ANA per history • Imaging or crystal analysis (clinical)

How the Testing Process Works

  1. Choose your start set: most people begin with serum uric acidESR/CRP, and BMP/CMP; add urinalysis for stone risk.

  2. Collection & timing: standard blood draw and urine sample; no fasting usually required. For 24-hour urine, follow the collection instructions exactly.

  3. Results & access: most results post within a few days to your secure account.

  4. Review with your clinician: results are interpreted with symptoms, exam, and (if needed) joint aspiration or imaging.

  5. Monitor over time: trending uric acid and inflammation markers helps clarify patterns and supports long-term planning.

Interpreting Results (General Guidance)

  • High serum uric acid (hyperuricemia): increases gout risk but is not diagnostic by itself.

  • Normal uric acid during a flare: gout is still possible—levels can dip transiently in acute attacks.

  • Elevated ESR/CRP: supports active inflammation; not specific to gout.

  • Low urine pH / high 24-hour urine uric acid: higher risk for uric acid stones and clues to urate handling.

  • Abnormal creatinine/eGFR: reduced kidney function affects uric acid levels and stone risk; clinicians adjust plans accordingly.
    Always interpret results with a qualified healthcare professional; patterns, timing, and crystal confirmationmatter most.

Choosing Panels vs. Individual Tests

  • Foundational panel (most adults): Serum uric acid • ESR/CRP • BMP/CMP • Urinalysis (pH)

  • Stone-risk focus: add 24-hour urine uric acid (± comprehensive stone-risk profile).

  • Rule-out focus: consider RF/anti-CCP/ANA if another inflammatory arthritis is suspected.

  • Monitoring: repeat uric acid and selected markers on the same method to compare trends accurately.

FAQs

Can I have a normal uric acid level during a gout attack?
Yes. Uric acid can be normal during flares; diagnosis relies on the full picture and, ideally, crystal analysis.

What test proves gout?
Synovial fluid crystal analysis confirms MSU crystals and is the diagnostic gold standard (performed by a clinician).

Do I need to fast for gout testing?
Usually no. Follow any specific instructions for a 24-hour urine collection.

Does a high uric acid level mean I definitely have gout?
No. Many people have asymptomatic hyperuricemia. Results must be read with your symptoms and exam.

How does kidney function affect gout?
Lower eGFR can raise uric acid and increase stone risk; kidney labs help tailor your care plan.

Can other conditions mimic gout?
Yes—septic arthritispseudogout (CPPD), rheumatoid arthritis, and injuries can look similar. Testing helps tell them apart.

Is genetic testing ever used?
In some settings, clinicians may order HLA-B*58:01 or other safety tests before certain medicines. Decisions are clinician-directed.

Related Categories & Key Tests

  • Inflammation Tests Hub

  • Arthritis Tests • Rheumatoid Arthritis • Osteoarthritis • Kidney & Urinary Health • Kidney Stone Risk • Metabolic Syndrome

  • Key Tests: Serum Uric Acid • ESR • CRP/hs-CRP • CBC with Differential • BMP/CMP (Creatinine/eGFR, LFTs) • Urinalysis with pH • 24-Hour Urine Uric Acid • RF • anti-CCP • ANA • (Clinical)Synovial Fluid Crystal Analysis

References

  • American College of Rheumatology — Gout classification criteria and diagnostic considerations.
  • European Alliance of Associations for Rheumatology (EULAR) — Recommendations for gout diagnosis and comorbidity assessment.
  • National Kidney Foundation — Kidney stone risk factors and urine pH guidance.
  • Up-to-date clinical reviews on serum/urine uric acid testing and interpretation in gout.
  • Clinical laboratory texts on synovial fluid crystal analysis and inflammatory markers.

Available Tests & Panels

Your Gout Tests menu is pre-populated in the Ulta Lab Tests system. Start with serum uric acidESR/CRPBMP/CMP, and urinalysis (pH); add 24-hour urine uric acid for stone risk or recurrent flares, and consider rheumatologic exclusions if the diagnosis is unclear. Follow collection instructions—especially for 24-hour urine—and review results with your clinician to plan next steps and monitoring.

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Most Popular

The Uric Acid Test measures uric acid levels in blood to assess kidney function and detect gout, a form of arthritis caused by uric acid buildup. High levels may also signal kidney disease, kidney stones, or metabolic disorders, while low levels can occur with liver disease. Doctors use this test to investigate joint pain, swelling, or frequent urination, and to monitor treatment for gout, kidney stones, or chemotherapy-related complications.

Blood
Blood Draw
Also Known As: Serum Urate Test


The Rheumatoid Factor (RF) Test measures RF antibodies in blood to help diagnose rheumatoid arthritis and other autoimmune conditions. High RF levels may indicate rheumatoid arthritis, Sjögren’s syndrome, or other connective tissue diseases, though they can also appear in some infections. Doctors order this test to investigate joint pain, stiffness, or swelling. Results provide important insight into autoimmune activity, joint health, and inflammatory disease management.

Blood
Blood Draw
Also Known As: RF Test, Rheumatoid Arthritis Factor Test

The ANA Screen IFA with Reflex to Titer and Pattern Test detects antinuclear antibodies in blood to evaluate autoimmune activity. If positive, further testing identifies antibody concentration (titer) and fluorescence pattern, helping diagnose conditions like lupus, rheumatoid arthritis, or Sjögren’s syndrome. Doctors order this test to investigate symptoms such as joint pain, fatigue, rash, or swelling and to guide treatment for autoimmune and connective tissue disorders.

Also Known As: ANA Test, Antinuclear Antibody Screen Test

The Complete Blood Count with Differential and Platelets Test is a comprehensive blood test that checks red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. The differential analyzes types of white blood cells to detect infections, anemia, clotting abnormalities, immune conditions, and certain cancers. This essential test is often ordered for routine health exams, diagnosis, and monitoring treatment progress.

Blood
Blood Draw
Also Known As: CBC Test, CBC with Differential and Platelets Test, CBC w/Diff and Platelets Test, Full Blood Count Test, Complete Blood Count Test

The Comprehensive Metabolic Panel (CMP) Test measures 21 markers to assess metabolic health, liver and kidney function, and electrolyte balance. It includes glucose, calcium, sodium, potassium, chloride, CO2, albumin, globulin, A/G ratio, total protein, bilirubin, ALP, AST, ALT, BUN, creatinine, BUN/creatinine ratio, and eGFR. The CMP helps detect diabetes, liver or kidney disease, and supports routine screening and chronic condition monitoring.

Blood
Blood Draw
Also Known As: CMP Test, Chemistry Panel Test, Chem Test, Chem 21 Test, Chem 14 Test 

Most Popular

The Cyclic Citrullinated Peptide (CCP) IgG Antibody Test helps diagnose rheumatoid arthritis by detecting antibodies strongly linked to autoimmune joint disease. A positive result may indicate early or developing RA, even before symptoms appear. Doctors order this test for patients with joint pain, stiffness, or swelling. Results, often used with the rheumatoid factor (RF) test, provide valuable insight into autoimmune activity and long-term joint health management.

Blood
Blood Draw
Also Known As: Anti-CCP, Cyclic Citrullinated Peptide IgG Antibody Test

Most Popular

The Immunoglobulin G (IgG) Test measures IgG antibody levels in blood to assess immune system function and long-term response to infections. Low IgG may indicate immune deficiencies or recurrent infections, while high levels may signal chronic inflammation, autoimmune disease, or certain infections. Doctors use this test to evaluate unexplained illness, monitor immune disorders, or assess overall immunity. Results provide vital insight into immune health and disease management.

Blood
Blood Draw
Also Known As: Immunoglobulin G Test, Immunoglobulin G Antibody Test, IgG Antibody Test

The IgG Subclasses Panel measures four IgG antibody subclasses (IgG1, IgG2, IgG3, IgG4) to assess immune system function. Abnormal levels may indicate primary immunodeficiency, recurrent infections, autoimmune disease, or allergic conditions. Doctors order this test for patients with chronic sinus, lung, or ear infections or suspected immune imbalance. Results provide key insight into antibody response, guiding diagnosis, treatment, and long-term immune monitoring.

Blood
Blood Draw
Also Known As: IgG Subclasses Test

Most Popular

The Sed Rate Test, also called the ESR Test, measures how quickly red blood cells settle in a sample of blood. A faster rate may signal inflammation caused by infections, autoimmune diseases, arthritis, or other chronic conditions. Doctors use this test to investigate unexplained fever, joint pain, or muscle aches, and to monitor inflammatory disorders such as lupus or rheumatoid arthritis. The Sed Rate Test provides important insight into overall inflammatory activity.

Blood
Blood Draw
Also Known As: Erythrocyte Sedimentation Rate Test, ESR Test, Sedimentation Rate Test, Westergren Sedimentation Rate Test

The Sedimentation Rate Blood Test, also called the Erythrocyte Sedimentation Rate (ESR) Test, measures how quickly red blood cells settle in a sample. A faster rate can signal inflammation linked to arthritis, autoimmune disease, or infection. Doctors order this test when patients have symptoms like joint pain, fever, or fatigue. While not diagnostic alone, results provide valuable insight into inflammatory activity and help guide further evaluation and treatment.

Blood
Blood Draw
Also Known As: Sed Rate Test

Blood, Urine
Blood Draw, Phlebotomist, Urine Collection

Gout is on the rise, and now over 8 million adults in the US suffer from this painful condition. Gout isn't something you take a pill for and forget about.

Gout can cause joint damage and long-term health complications, and a uric acid test can give you the answers you need.

It's time to take control of your health and feel better today. Gout symptoms don't have to control your life.

If you're wondering if you have gout, then keep reading this guide to learn all about gout and the reasons and benefits of a uric acid test.

What is Gout

Gout is as common as it is complex. Gout is a type of arthritis that causes excruciating pain, stiffness, tenderness, and swelling in your joints. Gout typically affects the base of the joint of your big toe.

Gout attacks come on quickly, often waking you up in the middle of the night making you think your big toe is up in flames. Gout comes and goes, and the leading cause is high levels of uric acid, which forms crystals.

High uric acid levels are usually due to issues with the kidneys and your body producing too much uric acid. Typically uric acid dissolves and passes through your kidneys. But with gout, the balance is disrupted, and uric acid builds up, forming sharp urate crystals in your joints.

Often gout starts silently, only with high uric acid levels. If you catch it in this stage, it's possible to reduce your uric acid to avoid painful attacks.

Risk factors for Gout

The higher your uric acid levels are, the more likely you'll develop gout. Things that increase your uric acid level include:

Your diet can play a massive role in causing gout. Eating a diet full of red meat and beer will dramatically increase your chances of getting gout.

Your weight can also play a part in uric acid production. When you're overweight, your body makes more uric acid, and your kidneys can't keep up with eliminating the excess.

Medical conditions like obesity, untreated high blood pressure, diabetes, and heart and kidney disease increase your risk of developing gout. But also certain medications you take for high blood pressure like beta-blockers do.

Men tend to have higher uric acid levels than women, so you're more at risk if you're a man. Men also typically develop gout earlier than women, between the ages of 30 and 50.

If you have family members with gout, then you're more likely to develop it too. Also, having surgery or a traumatic accident can sometimes cause a gout attack.

Causes of Gout

When too many urate crystals accumulate in your joints, you get inflammation and severe pain, known as a gout attack. Uric acid crystals cause gout. When uric acid levels become too high in your blood, it leads to urate crystals.

Your body also produces uric acid when it breaks down foods that contain purines. Purines are found in foods like organ meats, red meat, mussels, scallops, and trout. Purine is also in alcohol, especially beer and drinks flavored with fructose. 

Signs and Symptoms of Gout

The signs of gout symptoms come on suddenly and most often in the middle of the night. Symptoms you'll notice include:

  • Intense and crippling joint pain, usually in your big toe
  • Pain is most severe for the first 4 to 12 hours
  • Redness and inflammation
  • The inability to move your joint normally

While gout usually affects your big toe, it can affect your elbows, fingers, wrists, and knees. 

If you experience sudden and excruciating pain in your joints, then contact your doctor as soon as possible. Untreated gout leads to joint damage and more pain in your future.

Complications of Gout

Gout can lead to more severe conditions like recurrent gout attacks, which eventually cause significant destruction of your joints. If gout is left untreated, it can turn into advanced gout.

In this case, deposits form under your skin and create nodules that become swollen during gout attacks.

Kidney stones are also a complication of gout. Urate crystals collect in your urinary tract when you have gout. This collection of crystals can cause large stones and kidney damage if left untreated.

Diagnosis of Gout

Your doctor can typically diagnose gout based on how your joint looks and the symptoms you have. To confirm the diagnosis, they will usually order different uric acid tests.

X-rays of the joint are helpful to make sure nothing else is causing your inflammation. Ultrasound imaging can also detect urate crystals in your joints.

Sometimes doctors will also do a joint fluid test. A needle draws out fluid from your joint for microscopic examination.

And finally, your doctor will want you to have bloodwork to check your uric acid levels.

Lab Tests for Gout

To diagnose gout, your doctor will order a uric acid lab test. Higher than normal uric acid levels are a great indicator of gout, but other health conditions need to be ruled out.

High uric acid levels require further investigation, as there could be other causes like leukemia, cancers, chronic kidney disease, and pregnancy complications. 

You'll see low uric acid levels with kidney disease, long-term alcohol use, and lead poisoning.

Your doctor may also check a comprehensive metabolic panel (CMP) and a complete blood count (CBC) to assess your overall health and rule out other conditions.

Other tests, such as ANA, or antinuclear antibody, and RF, or rheumatoid factor, can be done to rule out various other potential sources for arthritis symptoms. A synovial fluid or blood culture might be necessary if there is suspicion of septic arthritis. 

Treatment for Gout

Treatment for gout focuses on reducing your uric acid levels and reducing inflammation. 

Medications for gout include over-the-counter medications like Advil or Aleve. Doctors will often prescribe you a more potent anti-inflammatory for the beginning stages of a gout attack.

Steroid medications and Colchicine can effectively reduce your gout pain along with drugs like Aloprim, which reduces the amount of uric acid your body makes.

You'll also need to make lifestyle changes like limiting alcohol, eating less red meat, and exercising daily.

Gout FAQS

Did you know gout is among the earliest recognized diseases? The Egyptians first identified gout around 2000 BC, as did Hippocrates in the fifth century BC. 

Hippocrates called gout the "un-walkable disease" and associated it with affluent lifestyles where people could afford fine red meats and alcohol. Throughout history, people also called gout the disease of kings. And having gout was thought to signify wealth and class.

Uric Acid Test

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Order your uric acid lab test today, and your results will be provided to you securely and confidentially online in 24 to 48 hours for most tests.

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