An inflammatory arthritis characterized by sudden and severe attacks of joint pain, swelling, and redness. It is caused by the deposition of urate crystals and surrounding tissues, leading to inflammation and pain.
Risk Factors for Gout
Elevated uric acid levels: Elevated uric acid levels in the blood, known as hyperuricemia, significantly increase the risk of developing gout
- Diet: Consuming foods rich in purines and alcohol can elevate uric acid levels, increasing the experiencing gout attacks.
- Obesity: Excess body weight leads to increase uric acid production and decreased excretion, increasing the risk of gout.
- Genetics: A family history of gout or inherited metabolic disorders affecting uric acid metabolism can predispose individuals to gout.
Clinical Presentation
- Acute gout attacks: There will be a sudden onset of intense joint pain, typically affecting the big toe (podagra), although other joints such as the ankle, knee, or wrist may also be involved.
- Chronic gout: Recurrent gout attacks may lead to chronic joint damage, tophi formation (accumulation of urate crystals), and joint deformities.
Diagnostic Evaluation
- Joint aspiration: Examination of synovial fluid from an affected joint under a microscope can reveal the presence of urate crystals, confirming the diagnosis of gout.
- Blood tests: Measurement of serum uric acid levels can help assess the degree of hyperuricemia, although normal levels do not rule out gout during an acute attack.
- Imaging studies: X-rays or ultrasounds are performed to assess joint damage and the presence of tophi.
Acute Management of Gout Attacks
- Medications are used to relieve pain and reduce inflammation during acute gout attacks.
- An anti-inflammatory medication used alone or in combination with for the treatment of acute gout attacks.
Regularly monitor serum uric acid levels and adjust ULT dosage to maintain target uric acid levels (<6 mg/dL) and prevent gout flares.
Complications of Untreated Gout
It results in joint damage, tophi formation (crystal deposits causing pain and swelling in soft tissues), and renal issues such as kidney stones or kidney disease due to chronic high uric acid levels.
Gout is a common and debilitating form of arthritis characterized by severe joint pain. Management of gout involves acute treatment of gout attacks, long-term prevention through lifestyle modifications and medication therapy, and monitoring to prevent complications. Patient education and treatment adherence are crucial in effectively managing gout and improving overall quality of life.
