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Table 97.3

Urgent Investigation for Suspected Acute Gout or Pseudogout

  • X-ray of involved joints
  • Aspiration of involved joint (samples for crystal analysis, microscopy and culture)
  • Blood culture (×2) if febrile
  • Creatinine and electrolytes
  • Urate level (may be normal in acute gout; gout and pseudogout may coexist)
  • Full blood count

If pseudogout confirmed:

  • Bone profile: calcium and phosphate, alkaline phosphatase
  • Magnesium
  • Ferritin, serum iron and total iron binding capacity (to assess for haemochromatosis)
  • Thyroid stimulating hormone (hypothyroidism and pseudogout often coexist)
  • Parathyroid hormone levels (if hypercalcaemia)