What is Gouty Arthritis?

Gout is the most common inflammatory arthritis. It is very painful to those affected. It is more common in men than in women. 

Cause

Gout is a type of inflammatory arthritis that causes crystal deposition, specifically monosodium urate. Gout occurs when the amount of uric acid in the body builds up and it may form needle shaped crystals in and around the joint. 

Risk Factors 

- overweight or obese 

- metabolic syndrome 

- chronic kidney disease 

- hypertension

- being on certain medications like diuretics, low dose aspirin, niacin, cyclosporin 

Symptoms

A gout flare may cause pain, swelling and redness at the affected joint. Depending on the joint affected it may cause limitation in functioning.

The first toe is usually the most commonly affected area. Other areas that can be affected include tendons, bursa, joint and kidneys. Gout can cause uric acid buildup leading to kidney stones. 

Diagnosis

Gout is usually diagnosed based on history, physical exam and labs. Imaging may aid in the diagnosis. 

The most definitive way to diagnose is to get a specimen of the fluid from the joint or bursa and look for the actual crystals. 

The diagnostic criteria is based on a point system which looks at sex, with males being more prevalent, joint redness, prior flare of arthritis, first toe involvement, a history of hypertension or heart disease, and elevated urate in the blood. 

Treatment

The treatment of a gout flare should be started as soon as possible. Medications for acute gout flares may include steroids, anti-inflammatories and anti-gout agents. Steroids may be given as an intramuscular or intravenous injection, pill or as an injection into the joint 

Prevention

-If increased weight then weight loss would be beneficial

- Avoiding alcohol 

- Avoiding beverages that have high fructose corn syrup, such as sodas

- Decreased dietary purine intake ( animal products)