Gout

What Is Gout?

Gout is a kind of arthritis that occurs when uric acid builds up in the joints. It can be very painful. Typically it affects one joint at a time, although it can also involve many joints.

When you have gout, your body may make too much uric acid or have a hard time getting rid of the uric acid it produces. The uric acid levels build up in your joints and form crystals in the joint fluid. It’s these crystals that cause the joint to swell and become inflamed.

Why some people with high uric acid levels will develop gout and others won’t is unknown. Gout can run in families, though, and is more common in males, postmenopausal women, and people who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills that interfere with the removal of uric acid from the body, may also have higher levels of uric acid in the blood.

You may also be more likely to develop gout if you have:

• Diabetes
• Kidney disease
• Obesity
• Sickle cell anemia and other hemolytic anemias
• Leukemia and similar types of disorders

During a gout attack, you may experience pain in one or a few joints. The big toe, knee, or ankle joints are most often affected. The pain also frequently starts during the night and is often described as throbbing, crushing, or excruciating. The joint may also appear warm and red and is usually very tender (it may even hurt to lay a sheet or blanket over it).

Some people go months or even years between gouty attacks. Others will develop chronic gouty arthritis. If you have chronic gout, you can develop joint deformities and loss of motion in the joints and may have joint pain and other symptoms most of the time.

Diagnosis of Gout

Tests for gout that may be done by your health care provider include:

• Synovial fluid analysis (shows uric acid crystals)
• Uric acid - blood
• Joint X-rays (may be normal)
• Urine uric acid levels are sometimes performed
• Synovial biopsy is rarely performed when the diagnosis is unclear

Treatment at Penn

For sudden gout attacks and flare ups, your physician may recommend certain over-the-counter pain relievers. There are also other options — including prescription medications and injections — that can help relieve pain and reduce swelling and inflammation. Diet and lifestyle changes may also help prevent gout attacks. It’s important to work with a team of experts who can help you manage your condition and prevent future flare ups.

Penn Programs & Services for Gout