Gout

Gout is a painful type of inflammatory arthritis caused by high uric acid levels in the blood. When uric acid builds up, sharp urate crystals can form in the joints, leading to sudden, severe pain, swelling, redness, and inflammation, most commonly in the big toe.

Gout is caused by the buildup of uric acid in the blood. When uric acid levels become too high, urate crystals can form in the joints and trigger painful inflammatory attacks. Diet, genetics, kidney function, weight, hydration, alcohol intake, and other health factors may influence uric acid levels.

Common gout symptoms include sudden severe joint pain, swelling, redness, warmth, limited mobility, and lingering discomfort after the worst pain improves. Gout attacks often occur suddenly, frequently at night, and the pain may peak within 4 to 12 hours.

Gout most often affects the big toe, also called podagra. However, it can also affect the ankles, knees, elbows, wrists, fingers, and other joints. Advanced gout may lead to hard uric acid deposits under the skin called tophi.

A gout flare is a sudden attack of intense joint inflammation caused by urate crystals. During a flare, the affected joint may become extremely painful, swollen, red, warm, and difficult to move. Flares can last hours to days, and soreness may continue for days to weeks.

Gout is diagnosed through a combination of clinical evaluation, physical examination, blood tests, joint fluid analysis, and imaging. A rheumatologist may evaluate sudden joint pain, swelling, redness, uric acid levels, inflammation markers, and evidence of urate crystal deposits.

Blood tests for gout may include serum uric acid levels and inflammation markers such as CRP and ESR. Elevated uric acid can support the diagnosis, but some people with gout may have normal uric acid levels during an acute attack, so blood tests must be interpreted in context.

Joint fluid analysis is considered the gold standard test for gout. During this test, fluid is taken from the affected joint and examined under a microscope to identify uric acid crystals.

Imaging tests such as X-rays, ultrasound, and dual-energy CT scans may help evaluate gout. Ultrasound can detect early urate crystal deposits, X-rays can show joint damage in chronic gout, and dual-energy CT can identify uric acid deposits in the joints.

The fastest way to stop a gout attack usually involves early treatment with medications such as NSAIDs, colchicine, or corticosteroids when prescribed by a doctor. Resting the joint, applying ice packs, elevating the affected area, and staying hydrated may also help during a flare.

Acute gout attacks may be treated with NSAIDs such as ibuprofen, naproxen, or indomethacin, colchicine to help stop flare-ups, or corticosteroids such as prednisone or injections when NSAIDs or colchicine are not suitable.

Long-term gout treatment focuses on lowering uric acid levels and preventing future flares. Medications may include xanthine oxidase inhibitors such as allopurinol and febuxostat, uricosurics such as probenecid and lesinurad, or pegloticase for severe, refractory gout.

High-purine foods and drinks can increase uric acid levels and trigger gout flares in some people. Common triggers include red meat, organ meats, certain seafood such as anchovies, sardines, mussels, scallops, and tuna, sugary drinks, beer, liquor, and alcohol.

Staying hydrated, maintaining a healthy weight, and following a gout-friendly, low-purine, anti-inflammatory diet may help reduce uric acid levels. Cherries, berries, low-fat dairy, whole grains, vegetables, and plenty of water may support better gout management.

Yes. Rheumatologist OnCall provides expert care for gout through virtual and in-person consultations. The practice offers personalized treatment plans, acute flare guidance, long-term uric acid control, lifestyle and nutrition support, and direct access to rheumatology specialists without long wait times.