Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

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What is the only definitive method for diagnosing gout?

Performance of foot x-rays
Assessment of rheumatoid factor
Performance of a bone scan
Analysis of synovial fluid

The correct answer is: Analysis of synovial fluid

The definitive method for diagnosing gout is the analysis of synovial fluid, primarily through joint aspiration. This procedure allows for the identification of monosodium urate crystals, which are indicative of gout. The presence of these crystals confirms the diagnosis, as gout is characterized by the accumulation of uric acid crystals in the joints, leading to inflammation and pain. X-rays of the foot, assessment of rheumatoid factor, and bone scans may provide useful information for different conditions affecting the joints but do not specifically diagnose gout. X-rays can reveal changes in the joint that may suggest gout, like erosions, but they cannot confirm the presence of uric acid crystals. Rheumatoid factor is associated with rheumatoid arthritis, not gout. A bone scan, which evaluates the overall metabolic activity in bones, lacks specificity for gout as well. Thus, the analysis of synovial fluid directly identifies the causative crystals of gout, providing an accurate and definitive diagnosis.