Gout happens when uric acid crystals build up in the joints. This causes the joints to be inflamed. If the crystals build up in the kidneys, kidney stones may result.
Gout typically occurs if you have high levels of uric acid in your blood (called hyperuricemia). But, you could also have normal uric levels and still have gout.
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.
These factors increase your chance of developing gout. All causes of hyperuricemia are risk factors for gout.
Risk factors include:
Symptoms include:
Most people with gout have another attack within two years. This attack may affect many different joints. With recurrent gout, tophi can form. Tophi are chalky deposits of uric acid that commonly occur in the elbows and earlobes.
The doctor will ask about your symptoms and medical history, and perform a physical exam. A sample of fluid from the affected joint will be taken. This fluid will be tested for uric acid crystals.
Other tests may include:
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 a warm pad or an ice pack on the joint may ease the pain. Keeping the weight of clothes or bed covers off the joint can also help.
If you have recurrent gouty arthritis or an initial attack with hyperuricemia, you may be given medication:
In some cases, low-dose colchicine may also be used to prevent recurrent attacks.
If you are diagnosed with gout, follow your doctor's instructions .
To reduce your chance of getting gout:
RESOURCES:
Arthritis Foundation
http://www.arthritis.org/
American Arthritis Society
http://www.americanarthritis.org/
CANADIAN RESOURCES:
Arthritis Society of Canada
http://www.arthritis.ca/
Canadian Arthritis Network
http://www.arthritisnetwork.ca/
References:
Braundwald E, Fauci AS, Kasper DL, et al, eds. Complications of hyperuricemia. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw Hill; 2002.
Gout. The American College of Rheumatology website. Available at: http://www.rheumatology.org/public/factsheets/gout.asp . Updated June 2006. Accessed June 27, 2008.
Rott KT, Agudelo CA. Gout. JAMA. 2003;289:2857-2860.
Terkeltaub RA. Clinical practice. Gout. N Engl J Med. 2003;349:1647-1655.
*7/19/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 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.
Last reviewed February 2009 by Jill D. Landis, MD
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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