A 45-year-old male asked:
i have repeated painful swollen joints i have been told it is gout i have had the joint fluid analyzed 4 times and there have never been any crystals negative rheumatoid panel it affects fingers wrist foot ankle heel knee usually one at a time occasionall
5 doctor answers
Dr. James Cunnar answered
26 years experience Family Medicine
RF - rheum arthritis: You could have rheumatoid factor negative (rf-) rheumatoid arthritis. Not likely gout without crystals in fluid. Other possibilities are pseudo gout or lupus. You may want to see a rheumatologist.
Answered on Jun 11, 2017
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10 thanks
Dr. Alan Ettinger answered
48 years experience Podiatry
Uric acid: Have your uric acid checked.
Answered on Sep 28, 2016
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1 comment
Dr. Ronald Krauser commented
51 years experience Rheumatology
That has little value except if there is a confirmed diagnosis of gout. 8% of gouty attacks will have a normal serum uric acid at the time of the attack. If crystals are absent, it is not gout, period.
Jun 11, 2013
Dr. Keith Baldwin answered
14 years experience Pediatric Orthopedic Surgery
Check w your rheum: Having 4 negative joint aspirations makes gout less likely. Other multi joint problems (poly articular arthropathies) may not show up on rheumatoid panels, though a general inflammation test such as an ESR or CRP will normally be elevated). You should get a diagnosis bc many good medications are available to treat rheumatologic diseases today.
Answered on Sep 28, 2016
1
1 thank
Dr. Jeffrey Kass answered
27 years experience Podiatry
Other ways : To check for gout would be elevated uric acid in blood and by way of 24 hour urine. Tapping the joint is the definitive way. There are reasons the tap could be negative, however, i would advise a rheumatology work up with complete bloodwork to rule out causes other han gout.
Answered on Jun 11, 2013
1
1 comment
Dr. Ronald Krauser commented
51 years experience Rheumatology
If no crystals are seen under polarized light microscopy, it is not gout. There are no false negatives if multiple taps have failed to show the presence of crystals.
Jun 11, 2013
Dr. Ann Holland answered
27 years experience Podiatry
Small joint pain: Another possibility is psoriatic arthritis if some scaling skin or nail disease/dryness. Have seen many cases of this where fingers and toes are swollen one at a time along with generalized aching joints. Also have a lyme disease test //aso and consider infectious precursor (bacterial or parasitic organism, e.G, tick-born illness if you have visited or lived in ne areas us) to this disease process.
Answered on Dec 28, 2013
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