Gout is a type of arthritis and a metabolic disorder that may be inherited.
It is characterised by recurrent acute joint inflammation and pain (gouty arthritis) usually in the extremities, caused by crystals that are deposited in and around the joints. These crystals come from blood that contains markedly high concentrations of uric acid (urate), a waste product of digestion that is normally excreted in the urine.
Symptoms include heat, red and shiny skin, and extreme tenderness and pain in the affected joints. It tends to affect the peripheral joints, most often those in the big toe, but can also affect the knees, elbows, thumbs or fingers.
The arthritis may become chronic and cause joint deformity. Tophi – small, hard lumps of urate deposits – may also form around the ankles, hands, tips of the elbows and earlobes. The tophi may erupt, causing a discharge.
Collection of urate crystals in the kidneys can lead to kidney stones.
Not all persons with high urate levels in their blood (hyperuricaemia) develop gout, but the greater the degree and duration of hyperuricaemia, the greater the risk of crystal deposition and acute gout attacks. Gout is a common disease and one of the oldest in medical literature. One of the oldest drugs in therapeutics, colchicine, is used for the acute attack of gout.
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Previously reviewed byDr David Gotlieb, rheumatologist, MBChB FCP(SA), September 2004
Reviewed by Dr Ingrid Louw, rheumatologist, MBChB, MMED Int Med, (private practice), August 2011