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(Gouty Arthritis)


Gout is inflammation in and around joints due to uric acid crystals. It leads to painful, stiff joints.

Causes    TOP

Uric acid comes from the break down of purine from food or human cells. Sometimes the body makes too much uric acid or has difficulty passing uric acid out of the body through the kidneys. When uric acid levels get too high it may lead to the formation of uric acid crystals in joints and gout.

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.

  • Foods high in purines, such as organ meats, shellfish, some vegetables, and gravies
  • High-fructose drinks, such as sugar-sweetened sodas and orange juice
  • Excess alcohol, especially beer

Symptoms    TOP

Acute Gout

Symptoms may include:

  • Sudden onset of severe pain in an inflamed joint, usually starting in the big toe
  • Joints that are red, hot, swollen, and tender
  • Increased pain 24-48 hours after the onset of symptoms

Gout of the Big Toe

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Recurrent Gout

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:

Diagnosis    TOP

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:

  • A sample of fluid taken from the affected joint
  • Blood tests
  • Urine tests

Images may be taken of your bodily structures. This can be done with:

Treatment    TOP

Treatment depends on whether the gout is acute or recurrent.

Acute Gout

In general, the sooner treatment begins for an acute attack, the more effective it is. Treatment depends on:

  • The number of joints affected
  • Previous responses to treatment
  • Overall health

General Measures

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:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids—may be given orally or as an injection into the affected joint
  • Colchicine

Recurrent Gout

General Measures

General measures used to treat recurrent gout include:

  • A low purine diet
  • Alcohol avoidance
  • Gradual weight loss in those who are obese
  • Stopping or changing medications that may be causing recurrent gout
  • Increasing fluid intake


If you have recurrent gout, or you have kidney stones, tophi, or reduced kidney function, you may be given medications to:

  • Lower the production of uric acid
  • Increase the excretion of uric acid by the kidneys
  • Convert uric acid into a different byproduct

Prevention    TOP

To help reduce your chance of getting gout:

  • Eat a low-purine diet.
  • Limit how much alcohol you drink. Avoid binge drinking.
  • Drink a lot of fluids.
  • Lose weight gradually.


American Arthritis Society
Arthritis Foundation


Arthritis Society of Canada
Canadian Arthritis Network


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1/4/2011 DynaMed Plus Systematic Literature Surveillance 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 Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at:
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Updated 2013. Accessed June 29, 2015.
Last reviewed January 2018 by Michael Woods, MD FAAP
Last Updated: 1/11/2018

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