Gout finger joint
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Abnormal enlargement in joints that had been affected by injury or osteoarthritis are possible areas where gout can "set up shop."
This is particularly significant in older women on diuretics. The distal interphalangeal joints (DIP) are often affected by gout.
Particularly large deposits of monosodium urate in and around joints are called tophi. These are packed with crystals, inflammatory cells, fibrin, and debris. Tophi erode into the joints.
Examination of synovial fluid is the most accurate method for diagnosing gout. It may even be helpful in detecting gout during intercritical periods (the period between attacks).
Procedure. The procedure for taking a sample of synovial fluid from an affected joint is called aspiration:
• A needle attached to a syringe is inserted into the joint and suction is used to draw the fluid into the syringe.
• Local anesthesia is used.
• Following the procedure there can be some minor discomfort in the area where the needle was inserted, but it usually goers away quickly.
Aspiration of a finger joint is very helpful in substantiating the diagnosis of gout. Aspiration sometimes eases a patients symptoms by reducing swelling and pressure on the tissue surrounding the joint. Sometimes, injecting the joint with steroid after aspirating can also help relieve symptoms.
After the sample is taken, it is sent to a laboratory, where a specialist examines the sample through a microscope under polarized light. This special light will reveal the presence of monosodium urate (MSU) crystals, which will confirm a diagnosis of gout. The laboratory can also test the sample for infection.
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