Gout is a cause of acute joint pain and occurs at an earlier age in men than in women. Patients with gout have elevations in the blood of a component called uric acid. Most often these elevations occur because the kidney fails to excrete the uric acid as fast as it is made. Gradually crystals of uric acid deposit in the tissues. These deposits occur around joints, and the release of the crystals into the joint may cause the sudden development of arthritis. The joint becomes red, swollen, hot, and tender. The tenderness is extreme, and patients with fully developed gouty attacks are unable to sustain even a light touch on the joint such as from clothing or bed clothes.
Without treatment, the arthritis lasts several days to a week. Usually gout affects one joint at a time, although attacks involving several joints do occur. Classically, gout is associated with involvement of the joint in the great toe, but any joint may be involved.
If attacks recur, chronic arthritis may develop in the involved joint. Often deposits of uric acid called tophi distort and interfere with the smooth function of the joint. Tophi also may occur in other tissues, such as in the ear. Uric acid deposition can also cause kidney stones.
Your physician can often suspect the diagnosis of gout based on your history and the appearance of the inflamed joint. Blood tests may show an elevation in uric acid. If there is uncertainty about the diagnosis, fluid from the joint is tested for the presence of uric acid crystals.
Important Points in Treatment
The treatment of acute attacks of gouty arthritis is with anti-inflammatory drugs or a drug called colchicine. Once the acute arthritis is controlled, long-term treatment to block the production of uric acid may prevent further attacks and will protect the kidneys from the development of kidney stones as well.
Notify Our Office If ...
- You have sudden onset of a painful, red, or swollen joint.