Which symptom would best indicate a need for a 24-hour urine collection for uric acid?

The indication for a 24-hour urine collection for uric acid is primarily based on the assessment of uric acid excretion in the urine, which helps to understand the underlying cause of hyperuricemia (elevated uric acid levels in the blood) and potential gout or kidney stone formation. A collection result showing less than 600 mg of uric acid excreted in 24 hours suggests that the patient's hyperuricemia may be due to under-excretion rather than overproduction of uric acid. This information is crucial for guiding treatment strategies.

Severe joint pain can indicate a flare of gout, but it does not directly necessitate a urine collection without additional findings related to uric acid levels. Elevated serum uric acid levels are helpful for diagnosing conditions linked to urate metabolism but do not differentiate between under-excretion and overproduction without accompanying urine excretion data. The presence of kidney stones may suggest a need for further evaluation, but the exact cause of the stones (particularly if they are uric acid stones) should be assessed through urine analysis rather than just a general symptom. Therefore, the best indicator for a 24-hour urine collection for uric acid specifically is the assessment of urinary excretion levels, as detailed