Because there are no physical signs of high levels of uric acid in the blood, gout is usually diagnosed after an acute attack of gout symptoms. The first step is usually a uric acid blood test. High uric acid levels are associated with gout, but they do not automatically indicate the disease.
Following a test finding high uric acid levels, a joint aspiration is usually the next step. This test removes a sample of the fluid inside the affected joint and examines it under a microscope for urate crystals. Many doctors will not make a positive diagnosis of gout until the patient has had at least two episodes of acute symptoms.
Learn more about tests used to diagnose gout.