What is it?
Gouty arthritis, also known as gout, is a condition caused by the deposition and accumulation of needle-like uric acid crystals in the fluid and tissues of one or more joints. This causes inflammation, swelling, and severe pain in the joint. The most frequently affected joint is the big toe, but gout can also occur in the hands, wrists, knees, and feet. Attacks of gout may occur several times a year and last for several days. During these attacks, uric acid deposits may build up in
cartilage, tendons, and soft tissues. They may also form lumps called tophi under the skin and may accumulate in the kidneys, leading to kidney stones, and kidney damage. Most gout episodes are acute and last a few days, but the severity and frequency of attacks can increase, and some people may develop a chronic form of gout.
Uric acid is an end product of the breakdown of purines, found in all body tissues and in many foods. Uric acid is normally carried through the blood and eliminated in the urine. If production of uric acid is increased by the body or a person eats foods high in purine, or if the kidneys’ ability to eliminate uric acid decreases, then concentrations in the blood can rise (called hyperuricemia) and cause crystal formation. Gout develops more frequently in men than women and is more common in adults. People with type 2 diabetes, obesity, sickle cell anemia, and kidney disease have an increased risk of developing gout. Drugs such as cyclosporine, thiazide diuretics, and salicylates (aspirin) can interfere with uric acid excretion as can excess consumption of alcohol. In rare instances, a person may inherit a decreased ability to metabolize purines and so have an increased tendency to develop gout.
Gout must be distinguished from conditions that can cause similar symptoms, such as pseudogout, a condition caused by calcium pyrophosphate crystals, septic arthritis (caused by an infection in a joint), and rheumatoid arthritis (an autoimmune arthritis). The treatments of these conditions are different than those used in the management of gout.
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