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Note that serum uric acid may be normal during an acute attack and should be rechecked after the flare resolves Joint aspiration fluid is drawn from the affected joint to examine for urate crystals under polarised microscopy and to exclude septic arthritis Imaging plain X-rays detect joint damage in chronic gout, while ultrasound or Dual Energy CT (DECT) scans can identify crystal deposition in joints and soft tissues even between attacks An accurate diagnosis is essential because other conditions, including septic arthritis and pseudogout, can produce similar common symptoms of inflammation and joint swelling