Gout symptoms

Overview

Gout is inflammatory arthritis from uric acid crystal deposition. Attacks are sudden, red, hot, and often affect the big toe (podagra). Chronic gout needs ongoing uric acid lowering.

Symptoms to watch for

• Sudden severe joint pain, often overnight
• Red, swollen, hot joint
• Big toe most common; also ankles, knees, wrists
• Fever with attack

What else could this be?

• Septic arthritis (urgent)
• Pseudogout (calcium pyrophosphate)
• Cellulitis
• Rheumatoid arthritis

How it's diagnosed

Clinical picture is often diagnostic. Joint aspiration is gold standard. Serum uric acid may be normal during an attack.

Treatment

Acute: NSAIDs (indomethacin, naproxen), colchicine, or prednisone. Prevention: allopurinol or febuxostat when >2 attacks/year or complications. Low-purine diet, alcohol reduction.