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Detecting and Treating Gout

Detecting and Treating Gout

Dr. Stephen I. Katz

Stephen I. Katz, M.D., Ph.D., is director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
Photo: NIAMS

Committed to Understanding the Basics…

“Almost every household in America is affected in some way by diseases of the bones, joints, muscles, and skin,” says Dr. Stephen I. Katz, director of National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). “These disorders affect people of all ages, racial and ethnic populations, and economic levels.

“Gout is one of the most painful conditions that we study at the NIAMS. We will continue to pursue strategies to improve treatments and quality of life for people affected by the disease.

“The Human Genome Project has greatly increased our knowledge of gout. Because of it, we have a fuller understanding of what causes the disease, who gets it, and how to diagnose and treat it.

“I believe that scientific research into conditions of the bones, joints, muscles, and skin will continue to result in improved health for everyone. Comprehensive information dissemination to the public, to patients, and to their healthcare providers is also essential for continued progress.”

“We have a fuller understanding of what causes gout, who gets it, and how to diagnose and treat it.”


What Is Gout?

Gout is a form of arthritis that causes joint pain. It happens when uric acid, a bodily waste, deposits as needle-like crystals in your joints. The crystals cause swelling, redness, heat, pain, and stiffness.

In many people, gout first affects the joints of the big toe (a condition called podagra). Other spots can include the insteps, ankles, heels, knees, wrists, fingers, and elbows. Chalky uric acid deposits, called tophi, can also appear as lumps under the skin surrounding the joints and rims of the ear. Uric acid crystals also can cause kidney stones.

Look Out for Pseudogout

Pseudogout is another form of arthritis with symptoms similar to gout: acute periods of joint redness, warmth, pain, swelling, and stiffness. But the irritating crystals are calcium phosphate, not uric acid. Pseudogout is treated somewhat differently.

What Is Uric Acid?

Uric acid results from the breakdown of purines, which are a normal part of all human tissue. Normally purines dissolve and pass out of the body in urine.

What Are the Four Stages of Gout?

  • Asymptomatic (without symptoms) hyperuricemia – Elevated levels of uric acid in the blood (called hyperuricemia) but no other symptoms. This does not need treatment.
  • Acute gouty arthritis—Uric acid crystals build up in joints, causing sudden, intense pain, swelling and sometimes warmth and tenderness. Attacks are common at night and can be triggered by stress, alcohol or drugs, or the presence of another illness. Eating too many high-purine foods, such as liver, dried peas and beans, gravies and anchovies can produce uric acid crystals and increase the risk of gout.
  • Even without treatment, such flare-ups (or bouts) usually subside within 10 days. They may not happen again for months or even years. But over time they may last longer and occur more frequently.
  • Interval or inter-critical gout—The period between acute attacks, with no symptoms.
  • Chronic gout—The most disabling stage. It usually develops over a period of 10 years. The affected joints and sometimes the kidneys may have been permanently damaged. With proper treatment, most people do not progress to this stage.

Fast Facts

  • Gout is a form of arthritis.
  • Six million Americans suffer from gout.
  • Men between 40 and 50 are most likely to develop gout.
  • As many as 80 percent of people suffering from gout have a family history of the disease.
  • Gout can be controlled through diet, exercise and proper treatment.

To Find Out More


Winter 2012 Issue: Volume 6 Number 4 Page 16-17