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Gout is an important cause of joint inflammation. Specific treatment is available for gout, and arthrocentesis should therefore be considered in adults who present with acute monoarticular arthritis in order to determine the possible presence of monosodium urate or calcium pyrophosphate crystals. Crystal analysis should always be carried out if gout is suspected, provided that synovial fluid can be aspirated.Plasma urate (uric acid) level should be determined, but gout cannot be diagnosed (or excluded) on the basis of the urate level. If the patient uses diuretics, the first step is to consider whether it is possible to stop the diuretic therapy. Dietary advice should be given to all patients. The treatment aims to relieve symptoms and to reduce the plasma urate concentration to below 360 µmol/l.
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