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
Discussion
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)