Gout occurs when uric acid crystals build up in the joints. This causes the joints to be inflamed, causing pain.
Gout typically occurs if you have high levels of uric acid in your blood. A high level of uric acid in the blood is called hyperuricemia. However, you could also have normal uric levels and still have gout.
The uric acid can then form crystals in the joints causing the pain and inflammation.
The liver metabolizes uric acid, and the kidneys get rid of it through the urine. Levels of uric acid build up when:
If you have gout and hyperuricemia, your body doesn't eliminate enough uric acid.
Gout is more common in men over the age of 30 years, but gout can occur in men and women at any age. Other factors that may increase your risk of gout include:
Certain foods and beverages may also increase your chances of gout.
Symptoms may include:
Gout of the Big Toe
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Most people with gout have another attack. This attack may affect many different joints. With recurrent gout, tophi can form. Tophi are chalky deposits of uric acid that most commonly occur in the elbows and earlobes, but may form anywhere
Gout can also lead to other health problems, such as:
You will be asked about your symptoms and medical history. A physical exam will be done. A sample of fluid from the affected joint will be taken. This fluid will be tested for uric acid crystals.
Your bodily fluids may be tested. This can be done with:
Images may be taken of your bodily structures. This can be done with:
Treatment depends on whether the gout is acute or recurrent.
In general, the sooner treatment begins for an acute attack, the more effective it is. Treatment depends on:
Putting an ice pack on the joint may ease the pain. Keeping the weight of clothes or bed covers off the joint can also help.
Medications may include:
General measures used to treat recurrent gout include:
If you have recurrent gout, or you have kidney stones, tophi, or reduced kidney function, you may be given medications to:
American Arthritis Society
Arthritis Society of Canada
Canadian Arthritis Network
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Gout. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115215/Gout. Updated September 2, 2016. Accessed September 28, 2016.
Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Gout/default.asp. Updated April 2012. Accessed May 9, 2016.
Gout overview. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/gout.html. Updated July 2013. Accessed May 9, 2016.
Gout management - prevention of recurrent attacks. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T474277/Gout-management-prevention-of-recurrent-attacks. Updated November 4, 2016. Accessed May 9, 2016.
Gout management - treatment of acute attack. Available at: http://www.dynamed.com/topics/dmp~AN~T474276. Updated October 13, 2014. Accessed May 9, 2016.
1/4/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115215/Gout: Man CY, Cheung IT, Cameron PA, Rainer TH. Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute gout-like arthritis: a double-blind, randomized, controlled trial. Ann Emerg Med. 2007;49:670-677. Epub 2007 Feb 5.
1/4/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115215/Gout: Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304(20):2270-2278.
4/24/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115215/Gout: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed June 29, 2015.
Last reviewed June 2016 by Michael Woods, MD FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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