How can you best differentiate gout from cellulitis when aspiration of the joint is not possible?
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Physical examination using a diagnostic decision rule has moderate positive and negative predictive value for recognition of gout. (SOR: B, based on an exploratory cohort study.) The monosodium urate (MSU) crystals of tophaceous gout are detectable by ultrasound (US), which is more sensitive than X-ray evaluation. (SOR: B, based on cohort studies.)
Evidence Based Practice 15(4): 09-10.