Gout diagnosis can also be done through differential method. The most common of the differential diagnosis is septic arthritis. This is mostly done to the patients who do not show signs of improvement even after treatment. To help the health care provider with diagnosis, synovial fluid gram stain is performed together with culture.
This is usually done to confirm the presence of gout disease when the physician is in doubts and mistakes gout tophi for basal cell carcinoma simply because it is not in the joint of the patient (Tausche et al, 2009).