The bigger problem is, it mimic other illnesses. So, even a doctor might mistaken it for other illness for years (like me, I was diagnosed with young onset gout since 10 years ago!)
Discussion
The diagnosis is mainly by clinical observation. HLA B27 is both expensive, slow and unreliable. While MRI & Xray is diagnostic, some signs and symptoms are staring right at you
for my self, archilles tendon pain (enthesitis) was the give away, because i am not doing extreme sports, and that is definitely not a gout presentation
other key symptoms:
- not food related illness
- early morning pain
- multiple migratory joint pain
- family history / personal history of psoriasis
- stress related (for me it was my PhD)