A person with gout may not be diagnosed for some time if certain conditions are present.
Clinical reasons:
(1) The patient is young.
(2) The patient does not have tophi or gouty arthritis.
(3) The clinician is unfamiliar with gout and its risk factors.
(4) Arthritis is misdiagnosis as psoriatic arthritis, septic arthritis, etc.
(4) The serum urate concentration is normal or not measured.
Pathological reasons:
(1) There is a delay in testing of synovial fluid held at room temperature.
(2) There is failure to perform a polarized light exam.
(3) There was an error in performing a polarized light exam.
(4) Uric acid crystals were dissolved during routine tissue processing that uses aqueous solutions.
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Specialty: Surgery, orthopedic