Expertise for the Management of Gout

Causes & Symptoms of Gout

Gout is often an inherited condition linked to specific genes. Abnormalities in these genes cause overproduction of uric acid by the body and under-excretion by the kidneys, leading to high levels in the bloodstream. Although genetics play a significant role, other factors such as diet and lifestyle can also contribute to the development of gout.

Common symptoms include:

• Severe, sudden onset of pain in one or more joints.
• Swelling, redness and stiffness in the affected joint.
• Fever and chills (rarely).
• Visible deposits of uric acid crystals in the soft tissue or joints called tophi.

How Is Gout Diagnosed?

To diagnose gout, our experts will perform a physical exam and take a complete medical, family and lifestyle history. A diagnosis can often be confirmed based on your symptoms and the appearance of the affected joint. Additional testing may include:

• Joint fluid testing. A sample of fluid from the affected joint is taken and examined under a microscope. If crystals are visible, it supports a diagnosis of gout.
• Blood test. To measure the level of uric acid in your blood. This is not a definitive test, however, because some people can have elevated uric acid levels but no symptoms of gout.
• Imaging tests. An X-ray of the joint can help rule out other causes of joint inflammation and assess joint damage from gout crystals. Ultrasound or CT scans can also be helpful for detecting uric acid crystals in or around the joint.

Medical Management of Gout

Medication is often the first-line treatment for gout. The type of medications prescribed will depend on the frequency and severity of your symptoms and may include:

Medications to Manage Gout Flareups

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to help manage pain and inflammation. They may also be used in combination with uric acid lowering medications to help prevent flareups.
• Colchicine is effective in reducing inflammation in acute gout flareups. It may also be used in combination with uric acid lowering medications.
• Systemic corticosteroids may be given in oral, intravenous or intramuscular form to manage symptoms of inflammation and pain. However, they are usually avoided since many gout patients also have metabolic syndrome with high blood pressure, diabetes and obesity.
• Steroid injections that are administered directly into the affected joint(s).
• Biologic medications derived from living organisms, such as bacteria, viruses or human cells. These may be used to manage treatment-resistant cases of gout if other medications are ineffective or are not recommended because of an underlying health condition.

Uric Acid Lowering Medications

• Medications to block uric acid production.
• Medications to improve uric acid removal by the kidneys.

Additional Strategies to Manage Gout

• Regular monitoring and effective management of other health conditions often associated with gout flareups, including hypertension, diabetes, obesity and chronic kidney disease.
• Eat a healthy diet and limit purine-rich foods such as red meat and seafood. Purines are chemical compounds that form uric acid when metabolized.
• Avoid or eliminate alcohol.
• Maintain a healthy weight.