16 January 2026, Friday

What is Gout

Gout is a chronic metabolic disorder characterized by elevated uric acid levels in the body. As a result, monosodium urate crystals deposit in the joints and tissues, causing inflammation, severe pain, and eventually joint deformity.

 

Causes and risk factors

The main cause is hyperuricemia (persistent elevation of uric acid in the blood), which may be due to:

• impaired purine metabolism,
• decreased renal excretion of uric acid,
• excessive dietary intake of purines.

Risk factors:

• male sex, age over 40,
• alcohol consumption (especially beer and spirits),
• high intake of meat and seafood,
• obesity, metabolic syndrome, arterial hypertension,
• chronic kidney disease,
• genetic predisposition.

 

Types and classification

 

• Acute gout – sudden attacks of severe pain, usually at night, often involving a single joint (commonly the first metatarsophalangeal joint).

• Chronic gout – recurrent attacks, tophi formation, joint deformities.

• Atypical forms – polyarticular, subacute, asymptomatic hyperuricemia.

 

Main symptoms

• sudden, intense joint pain (often at night),
• swelling, redness, increased local temperature,
• restricted mobility,
• in chronic cases – tophi (deposits around joints, ear auricles),
• recurrent attacks with progressive involvement of new joints.

Diagnosis

• Clinical: typical gout attacks, presence of tophi,
• Laboratory: hyperuricemia, elevated inflammatory markers,
• Synovial fluid analysis: detection of monosodium urate crystals (gold standard),
• Imaging: X-ray (erosions, punched-out lesions), ultrasound (“double contour” sign), CT if necessary.

 

 

Modern treatment methods

During acute attack:

• NSAIDs (ibuprofen, naproxen, indomethacin),
• colchicine,
• short course of glucocorticoids in severe cases.

Intercritical (long-term therapy):

• allopurinol or febuxostat to lower uric acid levels,
• uricosuric agents (benzbromarone, probenecid) in patients with preserved renal function,
• lifestyle modification: weight reduction, alcohol abstinence, purine-restricted diet.

 

Possible complications and prevention

Complications: chronic gouty arthritis, joint deformities, tophi, chronic kidney disease, urate nephropathy, urolithiasis.

Prevention:

• regular monitoring of uric acid levels,
• dietary restriction of purines,
• avoidance of alcohol,
• adequate hydration,
• timely treatment of hyperuricemia.

 

When to see a doctor

• at the first episode of acute joint pain,
• if attacks occur more than 1–2 times per year,
• when tophi or joint deformities appear,
• in case of kidney disease or hypertension,
• if standard painkillers are ineffective.