Gout in the hip is harder to diagnose,  so make sure you see a rheumatologist

This page about gout in the hip was last reviewed or updated on 30 January 2018.

SUMMARY  The main message of this article about hip gout is to get it diagnosed as quickly as possible by undergoing a hip joint aspiration (aka arthrocentesis) if that is possible. And see an experienced rheumatologist.

Gout in the hip is not common but it happens, even if you have been told otherwise. If it is gout, it is very likely the gout sufferer will have suffered gout for some time, and in other joints. It is NOT likely that you’ll get gout in the hip, before gout in other places.  Hip gout is an example of where gout spreads, usually from a big toe. It can attack both hips and spread from one hip to the other. It is also a sign that gout is entrenched.

So here’s a typical hip gout sufferer’s statement: “I’ve had gout for 6 years. It used to be in the toes, and then it spread to the ankle. Now I feel gout pain in the hip.” 

Anyone who has gout, and has had a hip injury has a higher risk.


Sadly many sufferers go for a very long time, sometimes years, without gout in the hip being diagnosed correctly. Remember that gout is best diagnosed by a joint aspiration (aka arthrocentesis) (1) not by simply having high blood uric acid. A normal uric acid reading (7.0 mg/dL, men, and about 6.0 mg/dl women) or lower, would suggest it’s not gout, but aspiration is the real test. Many people have high uric acid but don’t have gout. So you need joint aspiration.

But the problem with hip aspiration is that the hips are difficult joints on which to perform aspiration successfully – by one account the success rate is under 50%. Your neigbourhood doctor is not likely to be able to do this. You must see a rheumatologist and maybe be passed on to another rheumatologist who is experienced at hip aspiration.

Gout in the hip is difficult to diagnose because it can be difficult to draw synovial fluid from the hips during aspiration. Rheumatologists will be better at this procedure than your neighbourhood GP (PCP). So for something like suspected hip gout,  your neighhbourhood doctor should definitely send you to a rheumatologist. (I am repeating this point to emphasise it).

Or find one yourself. If aspiration is too difficult, a diagnosis of hip gout is a judgement call. But the “good news” about a gout in the hip diagnosis is that almost certainly you will have gout because gout seldom strikes first in the hips. If you have been diagnosed with gout elsewhere in the body that is a strong sign your hip pain is gout.

Your hip pain can be many other ailments. Gout in the hip can be confused with other conditions such as pseudo gout, bursitis, arthritis, synovitis, bone chips, torn cartilage and others. If you have blood uric acid under 7.0 mg/dL, men, and 6.0 mg/dL women, that would suggest your troubles are not gout, but aspiration is the real test.

And can women get gout in the hip? Yes.

When gout attacks the hips there is a huge danger. That if the tophi stage of gout is reached a few years later, the tophi will eventually destroy the joint. Initially, an early symptom might be a sore hip.

So is it gout? Read our data-custom-mark="true"gout symptoms, gout diagnosis and gout’s untreated development page


Why does gout go for the hips? One explanation is that gout goes for joints and it has a tendency to attack those that have been previously injured. That’s why doctors want to know if there has been any previous hip injury. If someone has hip gout, it is very likely they’ve not treated their gout well. And that’s why it has spread. Now there is risk of serious damage to the hip joint. And hip malfunction. You can imagine what effect that would have on your mobility –there are stories of people crawling to the bathroom to get their meds.


How do you deal with hip gout? As with gout in other body areas, there is really no way of beating it that is special to the hips. Long term hip gout treatment is basically no different to treatment in other body joints. The only way to control gout is to lower uric acid to 6.0 mg/dL and below. This is the level at which the MSU gout crystals usually start to dissolve.

Is hip gout more difficult to treat than others? The diagnosis may be, but probably no. Unless it is very advanced at the tophi stage. You simply have to get your uric acid down. How you do that is the main subject of this gout website, and there are many ways.

What is a gout in the hip attack like? Sufferers report two kinds of pain…the deep, dull ache, and the stabbing, shooting pain. Your pain may depend on your body posture. That’s what some hip gout sufferers say. Change it to see if you can get gout relief a simple way.

Medication pain relief Indomethacin, corticosteroids, colchicine (take only as prescribed, and if you can, read our colchicine page ). It is  very unlikely weaker NSAIDS like ibuprofen (Motrin) and naproxen (Naprosyn, Anaprox, Aleve, Artagen, Xenobid),will work. But if they do, that’s a big plus.

Natural remedies for hip gout relief. Some hip gout sufferers have reported pain relief from the famous baking soda (bicarbonate of soda) remedy. But note the cautions on our baking soda pageCherries too might help – they have anti inflammatory properties and may reduce uric acid. Other natural pain relief methods are discussed on this website, as are natural methods of lowering uric acid, the key to gout control. An experienced rheumatologist will have good tips.

(1)    Also Known As: joint fluid aspiration, joint tap, synovial fluid aspiration  

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