Gout and Hyperuricemia
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD
Did You Know?
Fast Facts on Gout
Gout is one of the most painful forms of arthritis. It occurs when too much uric acid builds up in the body. The buildup of uric acid can lead to:
- Sharp uric acid crystal deposits in joints, often in the big toe
- Deposits of uric acid (called tophi) that look like lumps under the skin
- Kidney stones from uric acid crystals in the kidneys
For many people, the first attack of gout occurs in the big toe. Often, the attack wakes a person from sleep. The toe is very sore, red, warm, and swollen.
Gout can cause:
- Pain
- Swelling
- Redness
- Heat
- Stiffness in joints
In addition to the big toe, gout can affect the:
- Insteps
- Ankles
- Heels
- Knees
- Wrists
- Fingers
- Elbows
A gout attack can be brought on by stressful events, alcohol or drugs, or another illness. Early attacks usually get better within three to 10 days, even without treatment. The next attack may not occur for months or even years.
See more symptoms and signs of gout »
SOURCE: "Fast Facts About Gout," National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Department of Health and Human Services
What is gout? What is hyperuricemia?
Gout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that
deposit in tissues of the body, especially the joints. When crystals form in the joints it causes recurring attacks of joint
inflammation (arthritis). Chronic gout can also lead to deposits of hard lumps of
uric acid in and around the joints and may cause joint destruction, decreased
kidney function, and kidney stones.
Gout has the unique distinction of being
one of the most frequently recorded medical illnesses throughout history. It is
often related to an inherited abnormality in the body's ability to process uric
acid. Uric acid is a breakdown product of purines that are part of many foods we
eat. An abnormality in handling uric acid can cause attacks of painful arthritis
(gout attack), kidney stones, and blockage of the kidney-filtering tubules with
uric acid crystals, leading to kidney failure. On the other hand, some people
may only develop elevated blood uric acid levels (hyperuricemia) without having
arthritis or kidney problems. The term gout refers the disease that is caused
by an overload of uric acid in the body, resulting in painful arthritic attacks
and deposits of lumps of uric acid crystals in body tissues.
Gouty arthritis
is typically an extremely painful attack with a rapid onset of joint
inflammation. The joint inflammation is precipitated by deposits of uric acid
crystals in the joint fluid (synovial fluid) and joint lining (synovial lining).
Intense joint inflammation occurs as white blood cells engulf the uric acid
crystals and chemical messengers of inflammation are released, causing pain,
heat, and redness of the joint tissues.
Who is affected by gout?
Approximately 5 million people in the United States suffer from gout. (Did
you know that none other than Benjamin Franklin had terrible gouty arthritis!)
Gout is nine times more common in men than in women. It predominantly attacks
males after puberty, with a peak age of 75. In women, gout attacks usually occur
after menopause.
While an elevated blood level of uric acid may indicate an
increased risk of gout, the relationship between hyperuricemia and gout is
unclear. Many patients with hyperuricemia do not develop gout, while some
patients with repeated gout attacks have normal or low blood uric acid levels.
In fact, the blood level of uric acid often lowers during an acute attack of
gout. Among the male population in the United States, approximately 10% have
hyperuricemia. However, only a small portion of those with hyperuricemia will
actually develop gout.
Next: What are the risk factors for gouty arthritis? »
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