What is gout?
Gout is inflammatory arthritis caused by urate crystals in and around a joint. Attacks may begin suddenly and cause intense pain, warmth and swelling. The big toe is a familiar location, but knees, ankles and other joints may also be affected.
High blood urate (uric acid) is a risk factor, but not everyone with high uric acid has gout. A blood value alone does not settle the diagnosis.
Signs of a gout flare
- Severe joint pain that develops over a short period.
- Swelling, warmth, tenderness and sometimes redness.
- Difficulty walking or tolerating normal contact with the joint.
- Attacks that improve and may recur.
A first severely painful, hot or swollen joint, particularly with fever or feeling unwell, can be caused by infection. It requires urgent clinical assessment rather than assuming gout.
Diagnosis and blood tests
A clinician considers the symptoms, examines the joint and may order blood urate testing. Joint fluid examination for crystals can be helpful when needed. Ultrasound or other imaging may sometimes be used.
Urate levels can change during an attack, so interpretation requires medical context. A diagnosis should also consider other types of arthritis and joint infection.
Managing attacks and preventing recurrence
Depending on individual circumstances, clinicians may recommend anti-inflammatory medicines such as NSAIDs, colchicine or corticosteroids for an attack. Treatment choices depend on kidney function, other medicines and health risks.
People with recurrent gout or certain complications may benefit from monitored long-term urate-lowering therapy. Changes in diet and lifestyle may help but are not always a substitute for necessary medication.
Frequently asked questions
Does high uric acid always need medicine?
No. The decision depends on the complete medical situation, not just the laboratory number.
Can gout affect the knee?
Yes. Gout can occur in the knees, ankles and other joints.
How can I distinguish gout from infection?
A healthcare professional must assess a possibly infected joint urgently; symptoms may overlap.
Sources and editorial review status
Medical background information is available from these specialist and public-health organizations:
This page is general patient education and has not yet been individually medically reviewed or approved by Dr O P Garg. It does not replace clinical assessment, diagnosis or personal treatment advice.