Wentworth-Douglass Hospital
(603) 742-5252
Decrease (-) Restore Default Increase (+) font size
Physicians
Pay Your Bill Online
Pricing Estimates
Financial Assistance
Health Library
Health Insurance Marketplace Assistance
Interpreter and Communication Services
Surgery Preparation
Medical Records
Accountable Care Organization
Advance Directives
Clinical Research & Trials
Food and Nutrition Services
Back to Health Library   Print This Page Print    Email to a Friend Email

Uric acid crystals
Uric acid crystals


Definition:

Gout is a kind of arthritis that occurs when uric acid builds up in the joints.

  • Acute gout is a painful condition that typically affects one joint.
  • Chronic gout is repeated episodes of pain and inflammation, which may involve more than one joint.


Alternative Names:

Gouty arthritis - acute; Gout - acute; Hyperuricemia; Tophaceous gout; Tophi; Podagra; Gout - chronic; Chronic gout; Acute gout



Causes, incidence, and risk factors:

Gout is caused by having higher-than-normal levels of uric acid in your body. Your body may make too much uric acid, or have a hard time getting rid of uric acid. If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed.

Not everyone with high uric acid levels in the blood has gout.

The exact cause is unknown. Gout may run in families. It is more common in males, postmenopausal women, and people who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood.

The condition may also develop in people with:

The condition may occur after taking medicines that interfere with the removal of uric acid from the body.



Symptoms:

Symptoms of acute gouty attacks:

  • Symptoms develop suddenly and usually involve only one or a few joints. The big toe, knee, or ankle joints are most often affected.
  • The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating.
  • The joint appears warm and red. It is usually very tender (it hurts to lay a sheet or blanket over it).
  • There may be a fever.
  • The attack may go away in several days, but may return from time to time. Additional attacks usually last longer.

After a first gouty attack, people will have no symptoms. Some people will go months or even years between gouty attacks.

Some people may develop chronic gouty arthritis, but others may have no further attacks. Those with chronic arthritis develop joint deformities and loss of motion in the joints. They will have joint pain and other symptoms most of the time.

Tophi are lumps below the skin around joints or in other places. They may drain chalky material. Tophi usually develop only after a patient has had the disease for many years.

After one gouty attack, more than half of people will have another attack.



Signs and tests:

Tests that may be done include:



Treatment:

Treatments for a sudden attack or flare-up of gout:

  • Your doctor will recommend that you take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin as soon as your symptoms begin. You will need to take prescription-strength medicines for 4 - 10 days.
  • Your health care provider may occasionally prescribe strong painkillers such as codeine, hydrocodone, and oxycodone.
  • A prescription medicine called colchicine helps reduce pain, swelling, and inflammation.
  • Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
  • The pain often goes away within 12 hours of starting treatment, and is completely relieved in 48 hours.

Daily use of allopurinol or probenecid decrease uric acid levels in your blood. Your doctor may prescribe these medicines if:

  • You have several attacks during the same year
  • You have signs of gouty arthritis
  • You have uric acid kidney stones

Some diet and lifestyle changes may help prevent gouty attacks:

  • Avoid alcohol, anchovies, sardines, oils, herring, organ meat (liver, kidney, and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus, cauliflower, consomm√©, and baking or brewer's yeast.
  • Limit how much meat you eat at each meal.
  • Avoid fatty foods such as salad dressings, ice cream, and fried foods.
  • Eat enough carbohydrates.
  • If you are losing weight, lose it slowly. Quick weight loss may cause uric acid kidney stones to form.

See also: Kidney stones



Support Groups:



Expectations (prognosis):

Proper treatment of acute attacks allows people to live a normal life. However, the acute form of the disease may progress to chronic gout.



Complications:

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of acute gouty arthritis.



Prevention:

The disorder itself may not be preventable, but you may be able to avoid things that trigger your symptoms. Limit alcohol consumption and follow a low-purine diet.



References:

Keith MP, Gilliland WR. Updates in the management of gout. Am J Med. 2007;120:221-224.

Cameron MA, Sakhaee K. Uric acid nephrolithiasis. Urol Clin North Am. 2007;34:335-346.




Review Date: 6/17/2009
Reviewed By: Mark James Borigini, Associate Clinical Professor of Medicine, University of California, Irvine, Irvine, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com


Find What You Need

Events
Careers
Foundation
About Us
Contact
Directions
News
Social Media Agreement
Joint Notice
Web Privacy Policy
WDH Staff Portal

Centers & Services

Cancer Center
Cardiovascular Care
Joint Replacement
Women & Children's
Physician Offices
Other Services

Conditions & Treatments

Health Library

Support Services

Support Groups
Care-Van
Dental Center
Social Work
Food & Nutrition
Integrative Wellness
Spiritual Care
Concerns & Grievances
Homecare and Hospice

For Patients

Pay Your Bill Online
Pricing Estimates
Financial Assistance
Interpreter Services
Surgery Preparation
Medical Record Request
Advance Directives
Clinical Research & Trials

For Healthcare Professionals

Work and Life
Financial Well-Being
Career and Growth

The Wentworth-Douglass Health System includes:

 

Address

Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100