(Arthritis, Gouty; Gouty Arthritis)
by Jenna Hollenstein, MS, RD
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 identified by the term 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.
Risk Factors TOP
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.
Acute Gouty Arthritis
Symptoms may include:
Recurrent Gouty Arthritis
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 commonly occur in the elbows and earlobes.
Gout can also lead to other health problems, such as:
The doctor will ask 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.
Other tests may include:
Treatment depends on whether the gout is acute or recurrent.
Acute Gouty Arthritis
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.
If you have recurrent gouty arthritis, or you have kidney stones, tophi, or reduced kidney function, you may be given medications:
If you are diagnosed with gout, follow your doctor's instructions.
To help reduce your chance of getting gout:
American Arthritis Society
Arthritis Society of Canada
Canadian Arthritis Network
Gout. American College of Rheumatology website. Available at: http://www.rheumat... . Updated September 2012. Accessed July 12, 2013.
Gout. Arthritis Foundation website. Available at: http://www.arthrit... . Accessed July 12, 2013.
Gout. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated February 13, 2013. Accessed July 12, 2013.
Gout - treatment of acute attack. Available at: http://www.ebscohost.com/dynamed/what . Updated May 6, 2013. Accessed July 12, 2013.
Gout overview. American Academy of Family Physicians Family Doctor website. Available at: http://www.aafp.org/online/en/home.html . Updated March 2010. Accessed July 12, 2013.
Questions and answers about gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Gout/default.asp . Accessed July 12, 2013.
Rott KT, Agudelo CA. Gout. JAMA . 2003;289:2857-2860.
Terkeltaub RA. Clinical practice. Gout. N Engl J Med . 2003;349:1647-1655.
What is gout? National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Gout/gout_ff.pdf . Accessed July 12, 2013.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : 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's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA . 2010;304(20):2270-2278.
Last reviewed June 2013 by Michael Woods, MD
Last Updated: 6/1/2013