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A joint fluid analysis to look for uric acid crystals. This is the only certain way to diagnose gout.
A medical history and physical exam.
A test to measure levels of uric acid in blood. This may be done if your doctor can't safely get fluid from the affected joint.
A test to measure levels of uric acid in urine.
Imaging tests, like ultrasound and computed tomography.
While X-rays of hands and feet are sometimes useful in the late stages of gout, X-rays aren't usually helpful in the early diagnosis. Pain often causes people to seek medical care before any long-term changes can be seen on an X-ray. But X-rays may help to rule out other causes of arthritis.
Your doctor may evaluate you for lead poisoning if you've been exposed to lead in your job or through hobbies.