Gout diagnostic study of choice

• The diagnostic standard is synovial fluid or tophus aspiration with identification of monosodium urate crystals.
• Synovial fluid is aspirated from the inflamed joint by careful arthrocentesis.
• The sample is then analyzed for characteristic negatively birefringent monosodium urate crystals which appear needle-like structures of 1–20 μm in length under polarized microscopy. This is central to confirm the diagnosis of gout. 22303530 18299687
• It also helps in differentiating gout from acute calcium pyrophosphate crystal arthritis (pseudogout) and septic arthritis.16707533

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