Highlights & Basics
- Gout is characterized by acute onset of severe joint pain, with swelling, effusion, warmth, erythema, and or tenderness of the involved joint(s).
- Arthrocentesis with synovial fluid analysis shows strongly negative birefringent needle-shaped crystals under polarized light.
- Nonsteroidal anti-inflammatory drugs, colchicine, corticosteroids, or interleukin-1 inhibitors are used to treat acute disease.
- Uric acid-lowering drugs (e.g., allopurinol, febuxostat, or probenecid) may be used when long-term prevention of crystal deposition is indicated.
- Complications include joint destruction, kidney disease, and urolithiasis.
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History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
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Citations
National Institute for Health and Care Excellence. Gout: diagnosis and management. June 2022. [internet publication].[Full Text]
FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care Res (Hoboken). 2020 Jun;72(6):744-60.[Abstract]
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Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017 Jan;76(1):29-42.[Abstract][Full Text]
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63. American College of Radiology. ACR appropriateness criteria: chronic extremity joint pain - suspected inflammatory arthritis. 2016 [internet publication].[Full Text]
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88. Curiel RV, Guzman NJ. Challenges associated with the management of gouty arthritis in patients with chronic kidney disease: a systematic review. Semin Arthritis Rheum. 2012;42:166-178.[Abstract]
89. McKenzie BJ, Wechalekar MD, Johnston RV, et al. Colchicine for acute gout. Cochrane Database Syst Rev. 2021 Aug 26;8:CD006190.[Abstract][Full Text]
90. Stewart S, Yang KCK, Atkins K, et al. Adverse events during oral colchicine use: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther. 2020 Feb 13;22(1):28.[Abstract][Full Text]
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95. US Food and Drug Administration. FDA briefing document supplemental BLA 125319: Ilaris (canakinumab) for the following proposed indication: "ILARIS is indicated for the treatment of gouty arthritis attacks. ILARIS has also been shown to extend the time to the next attack and reduce the frequency of subsequent attacks."June 2011 [internet publication].
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