(Arthritis, Gouty; Gouty Arthritis)
- Too much uric acid is produced
- Not enough uric acid is eliminated
- Obesity, sudden weight gain, or rapid weight loss
- Age: over 40 years old
- Sex: male
- Family members with gout
- Diuretics, such as hydrochlorothiazide
- Certain medications, such as aspirin
High-purine diet (uric acid occurs when purines are broken down), for example:
- Liver and other organ meats
- Dried beans and peas
- Diet that includes high-fructose drinks, like sugar-sweetened sodas and orange juice
- Alcohol use, especially binge drinking
- Certain types of cancer or cancer treatments (such as, cytotoxic drugs)
- Medications (such as, antiseizure, anti-rejection medications)
- Kidney disease
Acute Gouty Arthritis
- Sudden onset of severe pain in an inflamed joint, usually starting in the big toe
- Joints that are red, hot, swollen, and very tender
- Increased pain 24-36 hours after the onset of symptoms
|Gout of the Big Toe|
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Recurrent Gouty Arthritis
- Blood and urine tests—to measure the level of uric acid in your blood and to assess kidney function
- X-ray—a test that uses radiation to take a picture of structures inside the body, especially bones; used to check for joint destruction
Acute Gouty Arthritis
- Onset of symptoms
- Number of joints affected
- Previous responses to treatment
- Overall health
Nonsteroidal anti-inflammatory drugs (NSAIDs), for example:
Corticosteroids—used if NSAIDs are not effective or not recommended
- A study found that people given corticosteroid plus acetaminophen had fewer adverse effects than those given NSAID plus acetaminophen.
- Colchicine—used to prevent gout attacks, but seldom used as a treatment for an acute attack; Note: This drug has many adverse effects, so it is rarely used first.
- Consume a low-purine diet.
- Avoid alcohol.
- If you're overweight, lose weight gradually. Rapid weight loss can cause a gout attack.
- Ask your doctor if any of your medications can cause high uric acid levels.
- Drink a lot of fluids.
- To lower the production of uric acid (such as, allopurinol)
- To increase the excretion of uric acid by the kidneys (such as, probenecid or sulfinpyrazone)
Arthritis Foundation http://www.arthritis.org
American Arthritis Society http://www.americanarthritis.org
Arthritis Society of Canada http://www.arthritis.ca
Canadian Arthritis Network http://www.arthritisnetwork.ca
Alan R. Medications for gout. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary. Updated August 27, 2010. Accessed September 16, 2010.
Braundwald E, Fauci AS, et al, eds. Complications of hyperuricemia. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw Hill; 2002.
Gout. The American College of Rheumatology website. Available at: http://www.rheumatology.org/public/factsheets/gout.asp. Updated June 2006. Accessed June 27, 2008.
Rott KT, Agudelo CA. Gout. JAMA. 2003;289:2857-2860.
Terkeltaub RA. Clinical practice. Gout. N Engl J Med. 2003;349:1647-1655.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Man CY, Cheung IT, Cameron PA, Rainer TH. Comparison of oral prednisolone/paracetamol and oral indomethacin/paracetamol combination therapy in the treatment of acute gout-like arthritis: a double-blind, randomized, controlled trial. Ann Emerg Med. 2007;49:670-677. Epub 2007 Feb 5.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Choi HK, Willett W, Curhan G. Fructose-rich beverages and risk of gout in women. JAMA. 2010;304(20):2270-2278.
- Reviewer: Rosalyn Carson-DeWitt, MD
- Review Date: 09/2011 -
- Update Date: 09/01/2011 -