Gout Diagnosis & Flare Prevention
Gout Specialists in Los Angeles, CA
Our board-certified rheumatologists treat gout for patients across Los Angeles and Southeast LA. We confirm the diagnosis, calm the acute attack, and lower the uric acid that drives it, so the flares stop coming back. From your first painful toe to a long-term plan that keeps you flare-free, we build it in one place with the testing and treatment you need on-site.
What Gout Does to Your Joints
Gout is a form of inflammatory arthritis caused by uric acid. When there is too much uric acid in your blood, it can form sharp, needle-like crystals inside a joint. Your body treats those crystals as invaders, and the immune response that follows is the swelling, redness, and searing pain of a gout attack.
The classic first target is the big toe, where an attack can hit overnight and leave the joint so tender that even a bedsheet feels unbearable. But gout can also strike the ankle, knee, midfoot, or wrist. A first flare often settles in a few days, which fools many people into thinking the problem is gone. It is not. The uric acid is still there, and without treatment the attacks usually return, last longer, and eventually damage the joint.
Left unmanaged for years, gout can form hard deposits called tophi under the skin and erode the joint itself. Our rheumatologists step in early, treat the pain, and address the cause, so patients across Los Angeles get lasting relief instead of waiting for the next attack.
How We Diagnose Gout: Uric Acid and Joint Testing
Gout is often mistaken for an infection, a sprain, or another type of arthritis, so getting the diagnosis right matters. We confirm it with a focused work-up rather than guessing from symptoms alone.
We measure the uric acid in your blood, examine the joint, and when needed draw a small sample of joint fluid to look for urate crystals under the microscope, which is the most definitive test. We may also use imaging, such as ultrasound or X-ray, to check for crystal buildup and joint damage. Here is how uric acid levels generally read.
| Serum Uric Acid | What It Means |
|---|---|
| Below 6.0 mg/dL | The treatment target for most gout patients |
| 6.0 to 6.8 mg/dL | Elevated; crystals can still form over time |
| Above 6.8 mg/dL | Saturation point, where uric acid crystallizes in the joints |
One important note: during an acute flare, blood uric acid can actually look normal or low, so a single normal level does not rule gout out. Your physician reads the number alongside your symptoms, your history, and your exam before confirming the diagnosis and deciding whether long-term treatment makes sense.
Gout Services We Provide in Los Angeles
Gout has two jobs: stop the attack you have now, and prevent the next one. Our team handles the whole path, from the first flare to the long-term plan that keeps uric acid under control.
Acute Flare Treatment
We bring an active attack under control quickly with anti-inflammatories, colchicine, or steroids, matched to your other health conditions, so you get relief without unnecessary risk.
Joint Aspiration & Crystal Analysis
When the diagnosis is unclear, we draw a small fluid sample from the joint and check it for urate crystals, the most definitive way to confirm gout and rule out infection.
Urate-Lowering Therapy
We prescribe and fine-tune long-term medication such as allopurinol or febuxostat, then track your levels to a clear target so the crystals dissolve and flares stop.
Infusion for Refractory Gout
For severe or tophaceous gout that has not responded to standard therapy, we offer advanced infusion treatment right in our in-house infusion center.
Diet & Trigger Counseling
We help you identify what is setting off attacks, from certain foods and alcohol to dehydration and medications, and build practical changes you can actually keep.
Long-Term Monitoring
Gout is a long-term condition. We recheck your uric acid, adjust your therapy over time, watch for side effects, and coordinate with your other doctors at every visit.
Gout Treatment Options We Prescribe and Manage
We match your treatment to your uric acid level, how often you flare, and your overall health, including your kidneys. The goal stays the same for every patient: end the attacks and stop new crystals from forming. Here are the main options our rheumatologists use.
- Flare relief: colchicine, NSAIDs, and steroids
- These calm an active attack fast. We choose among them based on how soon you started symptoms, your kidney function, and your other medications, and we explain how to use them at the first sign of a flare.
- Urate-lowering therapy: allopurinol and febuxostat
- These lower the uric acid your body makes so existing crystals dissolve and new ones stop forming. We start low, increase gradually, and track your blood levels to a target, usually below 6.0 mg/dL.
- Advanced therapy for refractory or tophaceous gout
- For patients who keep flaring or have visible tophi despite standard treatment, we offer infusion-based therapy delivered and monitored in our office.
- Diet, hydration, and lifestyle
- Every plan includes the basics that help: staying well hydrated, easing back on alcohol and high-purine foods, managing weight, and reviewing any medications that raise uric acid.
We tell you why we picked a given option, how to take it, and how we will track it, so you make the decision with full information rather than just filling a prescription.
When Should You See a Gout Specialist in Los Angeles?
A lot of people ride out gout attacks at home and hope they stop. Sometimes the gap between flares is long enough that it feels manageable. Other times, waiting lets the crystals build and the joint damage set in. Book an evaluation with our rheumatologists if any of these fit you.
- Sudden, severe pain, swelling, or redness in a joint, especially the big toe
- More than one gout attack, or attacks that are getting more frequent
- Flares that last longer or spread to more joints than they used to
- Hard lumps under the skin near joints, fingers, or ears, which may be tophi
- A high uric acid level found on routine blood work
- Gout alongside kidney disease, high blood pressure, or diabetes
- Trouble tolerating gout medications, or flares that continue despite treatment
Next step: call us and we will get you evaluated. Early treatment usually means fewer attacks and far less long-term joint damage.
Who Is at Risk, and How You Prevent Flares
Who Carries the Highest Risk
Gout is more common in men, in adults with higher uric acid levels, and in people with obesity, high blood pressure, diabetes, or kidney disease. A family history raises your odds, as do certain medications such as diuretics. Diet plays a role too: red meat, organ meats, shellfish, alcohol (especially beer), and sugary drinks all push uric acid higher. Risk rises with age, and in women it climbs after menopause.
How You Keep Flares Away
Stay well hydrated, keep alcohol and sugary drinks light, and go easy on high-purine foods like organ meats and shellfish. Reaching a healthy weight, staying active, and managing blood pressure and blood sugar all help. The most reliable prevention, though, is keeping uric acid at target on the right medication, which is exactly what we monitor and adjust at every visit.
Why Patients Across Los Angeles Choose Our Gout Team
We treat the cause, not just the pain. Anyone can hand you an anti-inflammatory. We lower the uric acid that drives your gout so the attacks actually stop, instead of returning every few months.
We test and treat under one roof. With joint analysis, in-office monitoring, and an on-site infusion center, we diagnose and manage your gout in one place without sending you across the county.
We explain treatment in plain language. When we start a urate-lowering medication, you learn why we picked it, what to expect early on, and how to handle a flare if one happens while levels settle.
We work with your other doctors. Because gout often travels with kidney disease, blood pressure, and diabetes, we coordinate with your primary care and other specialists so everything stays in sync.
Meet the Doctors Who Treat Gout
Our physicians are board-certified rheumatologists with deep experience in gout, autoimmune disease, and complex musculoskeletal care, treating patients across Los Angeles and the greater LA area.
Gilbert F. Gelfand, M.D.
Dr. Gelfand serves as Clinical Professor of Medicine at USC and Chief of Rheumatology at Rancho Los Amigos Medical Center, and he has cared for patients in the Los Angeles area for more than 30 years.
Tien-I Karleen Su, M.D., FACR
Dr. Su co-founded Amicus Arthritis and Osteoporosis Center and brings more than 10 years of rheumatology practice, with a focus on patient-centered joint care.
Susan Mansourian, M.D., FACR
Dr. Mansourian gives each patient an individual plan and helps people with complex rheumatologic conditions reach their best possible health outcomes.
Branden Ireifej, M.D.
Dr. Ireifej focuses on autoimmune and musculoskeletal conditions, including gout, and works through an evidence-based approach with shared decision-making at every step.
Frequently Asked Questions About Gout Care
What is the main cause of gout?
Gout is caused by too much uric acid in the blood, which can form sharp crystals inside a joint and trigger an attack. High uric acid can come from how your body processes it, your diet, certain medications, kidney problems, or a combination. Lowering uric acid is the key to long-term control.
What is a normal uric acid level?
Uric acid generally crystallizes above about 6.8 mg/dL, which is the saturation point. For people with gout, the treatment target is usually below 6.0 mg/dL, and sometimes lower if you have tophi. Your doctor reads the number alongside your symptoms and history, since levels can look normal during an acute flare.
Can gout be cured?
Gout cannot be permanently cured, but it can be very well controlled. With the right urate-lowering medication kept at target, the crystals dissolve over time and most patients become flare-free. The key is staying on treatment, not stopping once the pain goes away.
Do I need a referral to see a gout doctor?
It depends on your insurance. HMO plans usually require a referral from your primary care doctor, while PPO plans often let you book directly. Call our office and our staff will check your plan with you.
What should I do during a gout flare?
Rest the joint, keep it elevated, hydrate, and start the flare medication your doctor has prescribed as early as possible. If you are not already a patient or flares keep returning, call us at (562) 758-6600 so we can treat the attack and address the underlying uric acid.
Do you treat patients in Spanish?
Yes. We have Spanish-speaking physicians and staff and a Spanish-language section on our website for patients across Southeast Los Angeles.
Schedule an Appointment with a Gout Doctor
Gout does not have to keep coming back. Whether you are in the middle of a painful flare, you have had attacks before, or your blood work just showed high uric acid, our Los Angeles rheumatologists will confirm the diagnosis and build a plan that ends the cycle. Patients across Los Angeles trust us to treat the cause, not just the pain.