Gout: causes, symptoms, diagnosis and treatment

Written by: Top Doctors®
Published: | Updated: 14/12/2023
Edited by: Top Doctors®

Gout consists of episodes of very acute and painful joint inflammation. This inflammation is due to the presence of crystals of uric acid inside the joints. Salt crystals are mostly formed in joints and tendons as a result of elevated levels of uric acid in the blood (hyperuricemia), which are often associated with excessive dietary habits and with alcohol intake - especially excessive amounts of beer.

About 7% of men have high levels of uric acid in the blood, but only a minor percentage of them suffer gout when urate crystals form. Women who are fertile or during menopause can experience an increase in their uric acid levels, but gout is much less frequent, although it can occur in post-menopausal women, especially if they take diuretics.

Causes of gout

The most frequent causes of hyperuricemia and gout are excessive eating habits, metabolic syndrome (obesity, hypertension, diabetes, high cholesterol levels and blood lipids), and an increase in uric acid in the blood. Gout is never due to ingestion of a single or a few foods. Taking diuretics, kidney failure and, rarely, other diseases or genetic predisposition, also produce hyperuricemia and cause gout. It is sometimes associated with decreased renal function in which case it is particularly necessary to treat it.

 

The accumulation of urate crystals and gout attacks

It may take some time for the accumulation of urate crystals to generate the first gout attack. Most gout is manifested by acute and intense joint inflammation, almost always in a single joint, which changes from asymptomatic inflammation to intense inflammation. With the inflammation, the joint swells and its surface can become red, causing intense pain. The most common areas where gout appears are the base of the big toe, the instep, ankle, knee, wrist or any joint of the fingers.

 

Accurate and accurate diagnosis

The identification of crystals in the joint fluid allows an accurate diagnosis. A diagnosis based on the clinical characteristics of the disease and the existence of elevated levels of uric acid in the blood is not a confirmation. X-rays or magnetic resonance imaging cannot be used diagnose gout.

 

Other complications of gout

In addition to episodes that can be very painful and temporarily disabling (usually more frequent and intense as time goes by if not treated), joints at the end of limbs or extremities may become damaged or nodules close to some joints called tophi appear. The most disturbing consequence is that gout increases the risk of cardiovascular disease - such as myocardial infarction and other complications of atherosclerosis. Recently, it has been associated with impotence.

 

Treatment of disease

Gout is a disease with a very effective treatment and is considered curable, since the deposit of crystals is reversible by reducing the uricemia to normal levels. Episodes are easily treatable in general.

 Topdoctors

By Topdoctors
Cardiology


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