Alternative Names: Gouty arthritis - acute; Gout - acute
Causes, incidence, and risk factors:
Gout is caused by an overproduction of uric acid or a reduced ability of the kidney to get rid of uric acid. The exact cause is unknown. It is more common in males, postmenopausal women, and people who drink alcohol.
This article discusses acute gouty arthritis only.
Symptoms:
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 infected with signs of warmth, redness, and tenderness.
The attacks of painful joints may go away in several days, but may return from time to time. Additional attacks usually last long. Some people may progress to chronic gouty arthritis, while others may have no further attacks.
A prescription medicine called colchicine helps reduce pain, swelling, and inflammation associated with acute gout attacks. The medication decreases the inflammation caused by uric acid crystals within the joint. It does not decrease the uric acid levels in the bloodstream.
The pain often goes away within 12 hours of starting treatment, and is completely relieved in 48 hours. Daily use of colchicine or allopurinol helps prevent future attacks.
Your doctor may also recommend that you take non-steroidal anti-inflammatory drugs (NSAIDs) as soon as symptoms start to relieve pain and inflammation. Strong painkillers such as codeine may occasionally be prescribed.
Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
Drinking more fluids helps prevents the formation of kidney stones .
Sometimes, a diet low in purines is prescribed. Organ meats, beer, wine, and certain types of fish contain high levels of purines.
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:
Side effects of medications
Chronic gouty arthritis
Kidney stones
Kidney dysfunction
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 avoid to avoid things that trigger your symptoms. Limit alcohol consumption and follow a low-purine diet.
Review Date: 4/26/2007 Reviewed By: Steve Lee, DO, Rheumatology Fellow, Loma Linda University Medical Center, Loma Linda, CA. Review provided by VeriMed Healthcare Network.