05/06/2026
Gout Arthritis
A type of inflammatory arthritis caused by uric acid buildup. It’s one of the most painful types of arthritis, but also one of the most treatable.
1. What’s actually happening
1. *Uric acid*: Normal waste product when your body breaks down purines from food + your own cells
2. *Problem*: If you make too much uric acid, or your kidneys don’t flush it out well, levels get high = "hyperuricemia"
3. *Crystals*: Excess uric acid forms sharp, needle-like crystals called monosodium urate
4. *Attack*: These crystals deposit in joints. Your immune system attacks them → sudden, intense inflammation = a "gout flare"
Think of it like tiny glass shards in your joint.
2. Classic symptoms
1. *Sudden pain*: Usually starts at night. Hits fast, peaks in 12-24 hours. "Worst pain ever" is how patients describe it
2. *Location*: Big toe = 70% of first attacks = "podagra". But can hit ankles, knees, wrists, fingers, elbows
3. *Other signs*: Joint is hot, red, swollen, shiny skin. Even a bedsheet touching it hurts
4. *Pattern*: Attacks come and go. Early on you’re fine between flares. Over years, flares get more frequent if untreated
3. What triggers a flare
Common triggers that spike uric acid:
1. *Food/drink*: Red meat, organ meat, shellfish, beer, sugary drinks with high fructose corn syrup
2. *Dehydration*: Not drinking enough water
3. *Injury/surgery*: Trauma to a joint can kick off crystals
4. *Medications*: Some diuretics/"water pills", low-dose aspirin, cyclosporine
5. Illness.Sudden illness, fasting, crash diets
6. Genetics.Family history raises risk a lot
4. Who gets it
More common in: Men 30-50, postmenopausal women, people with obesity, high BP, diabetes, kidney disease. But anyone can get it.
5. Diagnosis
Doctors confirm with:
1. Joint fluid test. Gold standard - they pull fluid from the joint and look for uric acid crystals under microscope
2. Blood test: Uric acid level. But level can be normal during a flare, so not enough alone
3. Ultrasound/X-ray.Later stages show "tophi" = chalky crystal deposits, or joint damage
6. Treatment - 2 main parts
1. Stop the flare.NSAIDs like ibuprofen, colchicine, or steroids. Start ASAP when pain starts. Ice + rest + elevate joint helps
2. Prevent future flares*: Long-term meds like allopurinol or febuxostat lower uric acid. Goal is
