| What is Gout?Gout is a type of inflammatory arthritis | | | | 3-10 days. |
| that occurs in response to a build-up of crystals that | | | | 3. Intercritical period |
| are deposited in joints, soft tissue or bone. The | | | | This is the period between attacks. Generally, about |
| crystals are formed as a byproduct of purine | | | | 68% of people will experience another gout attack |
| breakdown that occur naturally in the body. About 5.1 | | | | or flare within the first year, 78% within 2 years and |
| million Americans are affected by gout. It affects | | | | 84% within 3 years. A small minority will never |
| men older than 40 more than women, although after | | | | experience another gout attack. During this |
| menopause, both men and women are equally | | | | intercritical period the individual remains pain free |
| affected. | | | | despite the fact that damage to the underlying |
| What Causes Gout?Uric acid is a natural byproduct of | | | | structures can still occur. |
| purine breakdown which is then eliminated by our | | | | 4. Advanced Gout |
| kidneys. Our bodies are not very efficient however in | | | | Over time, the persistence of crystals cause chronic |
| eliminating uric acid and thus a build-up occurs which is | | | | low-level inflammation that leads to joint damage and |
| known as hyperuricemia. Hyperuricemia is the | | | | build up of crystal deposits that are known as tophi. |
| precursor to gout although not everyone who has | | | | These deposits lead to joint erosion and deformities |
| hyperuricemia will get gout for reasons that are not | | | | that are clearly evident on X-ray or MRI. |
| well understood. This uric acid leads to crystal | | | | How is Gout Diagnosed?The gold standard for |
| formations that are deposited in joints, bones and | | | | diagnosis is to take a sample of joint fluid during an |
| soft tissue. These needle-like crystals can cause | | | | acute flare to analyze it for monosodium urate |
| excruciating pain that is often likened to breaking a | | | | crystals. However this is not always practicable during |
| bone. | | | | a medical exam. If the joint is not aspirated, a very |
| 4 Stages of Gout1. Asymptomatic hyperuricemia | | | | detailed history is taken, the affected joint is carefully |
| During this period, the person has no symptoms of | | | | examined and blood work is ordered because gout |
| gout but none-the-less, crystals are deposited and | | | | can mimic other diseases.That is why it is very |
| accumulate which then leads to a gout attack. Again, | | | | important to see your provider during an acute |
| why this occurs in some people with hyperuricemia | | | | attack. |
| and not others is not well understood. | | | | How is Gout Treated?During an acute flare, |
| 2. Acute gout attack | | | | treatment focuses on eliminating pain and disability as |
| Left untreated, an acute attack resolves | | | | quickly as possible. To this end several types of |
| spontaneously in 3 to 10 days. It is believed that the | | | | medications can be used. Since inflammation is an |
| inflammation and lower pH that occurs during the | | | | underlying condition, medications that target |
| attack eventually causes the crystals to dissolve. In | | | | inflammation are often used. |
| addition, some of the crystals become walled-off in | | | | Treatment of advanced gout focuses on reducing |
| tissue while other types of cells known as | | | | the level of uric acid since gout does not occur |
| macrophages may elicit an anti-inflammatory | | | | without hyperuricemia. The goal is to prevent erosive |
| response. Finally, specific proteins are thought to coat | | | | changes to bones, soft tissue and joint spaces that |
| the crystals which also suppress inflammation. These | | | | otherwise occur. Talk to your provider about |
| processes lead to a resolution of symptoms within | | | | treatment options that are best for you. |