Measurement of serum uric acid is the most misused test in the diagnosis of gout. The presence of hyperuricemia in the absence of symptoms is not diagnostic of gout. In addition, as many as 15% of patients with symptoms from gout may have normal serum uric acid levels at the time of their attack. Thus, the diagnosis of gout can be missed if the joint is not aspirated.
Remember that situations that decrease uric acid levels can trigger attacks of gout. In such cases, the patient's medical records may reveal prior elevations of uric acid.
For more on the workup of gout, read here.
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Cite this: Herbert S. Diamond. Fast Five Quiz: Are You Prepared to Confront Gout? - Medscape - Dec 10, 2015.
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