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Lake City, FL
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

4 doctor answers13 doctors weighed in
Dr. James Cunnar
Family Medicine 27 years experience
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.
Dr. Keith Baldwin
Pediatric Orthopedic Surgery 15 years experience
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.
Dr. Jeffrey Kass
Podiatry 28 years experience
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.
Dr. Ronald Krauser
A Verified Doctor commented
A US doctor answered Learn more
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
Podiatry 28 years experience
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.

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Last updated Jun 11, 2017

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