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Definition

Gout is a form of inflammatory arthritis characterized by recurrent attacks of a single red, tender, hot, and swollen joint.[1][2]

Symptoms 1

Pain typically comes on rapidly, reaching maximal intensity in less than twelve hours.[3] The joint at the base of the big toe is affected in half of cases.[4]

Symptoms 2

It may also result in tophi, kidney stones, or urate nephropathy.[3]

Cause 1

Gout is due to persistently elevated levels of uric acid in the blood.[3][2]

Cause 2

This occurs from a combination of diet, other health problems, and genetic factors.[3][2] At high levels, uric acid crystallizes and the crystals deposit in joints, tendons, and surrounding tissues, resulting in an attack of gout.[3]

Cause 3

Gout occurs more commonly in those who regularly eat meat or seafood, drink beer, or are overweight.[3][5]

Diagnosis

Diagnosis may be confirmed by the presence of crystals in the joint fluid or in a deposit outside the joint.[3] Blood uric acid levels may be normal during an attack.[3]

Treatment

Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine improves symptoms.[3][2][6]

Prevention

Once the acute attack resolves, levels of uric acid can be lowered via lifestyle changes or allopurinol.[3] Taking vitamin C and eating a diet high in low-fat dairy products may be preventive.[7]

Epidemiology 1

Gout affects about 1 to 2% of the Western population at some point in their lives.[3] It has become more common in recent decades.[3]

Epidemiology 2

Older males are most commonly affected.[3]

History

Gout was historically known as "the disease of kings" or "rich man's disease"[3][8] and has been recognized since at least the time of the ancient Egyptians.[3]

References

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