Gout is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation.
Gout is caused by having higher-than-normal levels of uric acid in your body. This may occur if:
If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed.
The exact cause is unknown. Gout may run in families. It is more common in men, in women after menopause, and those who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood.
The condition may also develop in people with:
The condition may occur after taking medicines that interfere with the removal of uric acid from the body.
Symptoms of acute gout:
After a first gouty attack, people will have no symptoms. Half of patients have another attack.
Some people may develop chronic gout. Those with chronic arthritis develop joint damage and loss of motion in the joints. They will have joint pain and other symptoms most of the time.
Tophi are lumps below the skin around joints or in other places. They may drain chalky material. Tophi usually develop only after a patient has had the disease for many years.
Tests that may be done include:
Not everyone with high uric acid levels in the blood has gout.
Medicines should be taken as soon as possible if you have a sudden gout attack.
Daily use of allopurinol or probenecid decrease uric acid levels in your blood. Your doctor may prescribe these medicines if:
Some diet and lifestyle changes may help prevent gouty attacks:
See also: Kidney stones
Proper treatment of acute attacks allows people to live a normal life. However, the acute form of the disease may progress to chronic gout.
Call for an appointment with your health care provider if you have symptoms of acute gouty arthritis.
The disorder itself may not be preventable, but you may be able to avoid things that trigger your symptoms. Limit alcohol consumption and follow a low-purine diet.
Gouty arthritis - acute; Gout - acute; Hyperuricemia; Tophaceous gout; Tophi; Podagra; Gout - chronic; Chronic gout; Acute gout; Acute gouty arthritis
Wilson JF. In the clinic. Gout. Ann Intern Med. 2010 Feb 2;152(3):ITC21.
Richette P, Bardin T. Gout. Lancet. 2010 Jan 23;375(9711):318-28.
Updated by: Ariel D. Teitel, M.D., M.B.A., Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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