Gout

Also known as: Gouty arthritis

A common inflammatory arthritis caused by uric acid crystals, known for sudden, severe attacks that often start in the big toe.

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Gout

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How it works · Gout

Uric acid is a normal waste product

Your body makes uric acid when it breaks down purines, found in your own cells and in some foods. The kidneys clear most of it.

What it is

Gout occurs when uric acid in the blood stays high enough to form crystals in and around joints. It is the most common inflammatory arthritis in men and becomes more common in women after menopause. Kidney disease, some medicines, alcohol and genetics all raise risk.

Symptoms

Sudden, intense pain, redness, warmth and swelling in a joint, often overnight, peaking within 24 hours. The big toe, foot, ankle and knee are most common. Over years, lumps of crystals called tophi can form.

How it’s diagnosed

The gold standard is seeing crystals in joint fluid under a microscope. Blood uric acid, ultrasound or dual-energy CT can support the diagnosis. Uric acid can be normal during an attack, so it is rechecked afterward.

Treatment

Flares are treated with colchicine, NSAIDs or steroids. To prevent attacks, urate-lowering medicine such as allopurinol is started at a low dose and increased until uric acid stays below 6 mg/dL, usually for life.

Living with it

Limit alcohol (especially beer), sugary drinks and large portions of red meat and shellfish. Stay hydrated, and keep taking urate-lowering medicine even when you feel well.

← Behçet’s Disease

Calcium Pyrophosphate Deposition Disease →

At a glance