I'm not sure why I missed seeing this discussion. I was diagnosed with gout in 2022. Very long post. My apologies.

After a small pan lid fell on my toe from about 4", that toe hurt and was slightly swollen ( not like the photos of gout tophi) for months. I had x-rays taken at about the six month "anniversary of the lid accident" by a Foot and Ankle Specialist whose comment was, " I can't see the break, come back in six weeks." By then, my nephrologist (!!) had deduced that my uric acid level should be measured. Three days later, when I had my quarterly appt with him, he gave me a prescription for colchicine which took care of the pain in quick order. I was tested for allergy to allopurinol, which apparently is common in East Asia (all my grandparents immigrated from Japan) and started taking it shortly after that.

Next came a referral to Rheumatology, the dept at my HMO that "handles" gout patients. The entrance requirement for a gout consultation was to have had a tophus from which uric acid crystals could be extracted and seen by a microscope. I hadn't done that step so I was told to get a Dual Scan CT instead. The (goofy) doctor said she didn't know where I could get that done but to come back when I did. Really?!?

In the meantime, my nephrologist said he'd be happy to help me with gout since I was already seeing him quarterly for my main health threat. I'm one of ten people in the world known to have a CKD called idiopathic ITG. A pathologist at the Mayo Clinic made the diagnosis after pathologists at my HMO and at the Hennepin County Medical Center in Minneapolis were unable to conduct the confirming test because they did not have a reagent the test called for. I searched the medical literature for info about ITG and for papers (if any) published by that Mayo pathologist. She happened to have published with a colleague in Nephology who also practices in Hematology. I think he took me on as a patient because he had never met an idiopathic ITG patient.

As it turns out, that Mayo doctor himself has gout. As he worked with me on the ITG problem he deduced that I might have another form of arthritis (that would make three for me: gout, osteoarthritis (for which I had total hip replacment in 2024) and, the new to me one, pseudogout. The Mayo Clinic must have every available medical test and scan because he was able to arrange for a Dual Scan CT for me the day after I had an appt with him. Of course, I do have pseudogout. I think that it got its name because it is one of only three known maladies for which colchicine provides relief: gout and Mediterranean Familial Fever are the other two.

There is no cure for pseudogout, nothing to prevent it from happening in new joints, just pain relief from taking colchicine which I now take daily. It mostly works but my nephrologist is considering increasing the dose.

The only other thing I should note (sorry for the length of my post! I'm a retired academic chemist) is that I've been told by both nephrologists and the rheumatologist I got to see after "the" Scan that red meat is the worst protein source for gout sufferers. I am told to avoid beef, pork, game, shellfish, fried foods, avocados, nuts, herring, sardines, and a few other odd foods I rarely ate in the past. I struggle with the diet limitations. I eat now not for enjoyment but to avoid the hiccups which come on if I am hungry. Go figure.