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Gout is a type of arthritis. It occurs when uric acid builds up in blood and causes inflammation in the joints.
Gouty arthritis - acute; Gout - acute; Hyperuricemia; Tophaceous gout; Tophi; Podagra; Gout - chronic; Chronic gout; Acute gout; Acute gouty arthritis
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 and become inflamed.
The exact cause is unknown. Gout may run in families. The problem is more common in men, in women after menopause, and people who drink alcohol.
The condition may also develop in people with:
Gout may occur after taking medicines that interfere with the removal of uric acid from the body. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood.
Symptoms of acute gout:
People will have no symptoms after a first gout attack. Many people will have another attack in the next 6-12 months.
Some people may develop chronic gout. This is also called gouty arthritis. This condition can lead to joint damage and loss of motion in the joints. People with chronic gout will have joint pain and other symptoms most of the time.
Tophi are lumps below the skin around joints or other places such as the finger tips and ears. Tophi can develop after a person has had gout for many years. These lumps may drain chalky material.
Tests that may be done include:
Not everyone with high uric acid levels in the blood has gout. A level over 7 mg/dL is high.
Take medicines for gout as soon as you can if you have a sudden attack.
Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin when symptoms begin. Talk to your health care provider about the correct dose. You will need stronger doses for a few days.
Your doctor may prescribe medicines you take daily (such as allopurinol or probenecid) to decrease uric acid levels in your blood. You may need these medicines if:
Diet and lifestyle changes may help prevent gouty attacks:
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 your health care provider if you have symptoms of acute gouty arthritis.
You may not be able to prevent gout but may be able to avoid things that trigger symptoms.
Khanna D, Fitzgerald JD, Khanna PP, Bae S, Singh MK, Neogi T, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care & Research. 2012;64(10):1431-46.
Khanna D, Khanna PP, Fitzgerald JD, Singh MK, Bae S, Neogi T, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 2: Therapy and antiinflammatory prophylaxis of acute gouty arthritis. Arthritis Care & Research. 2012;64(10):1447-61.
Choi HK. A prescription for lifestyle change in patients with hyperuricemia and gout. Current Opinion in Rheumatology. 2010;22(2):165-72.
Burns CM, wortmann RL. Clinical features and treatment of Gout. In: Firestein GS, Budd RC, Gabriel SE, et al, eds.Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap 95.
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