Acute gouty arthritis
Key points
- Acute gouty arthritis is an attack of a metabolic disease marked by uric acid deposits in the joints.
- Gout is caused by a defect in metabolism that results in an overproduction of uric acid, or a reduced ability of the kidney to eliminate uric acid.
- Signs and tests A physical examination of the joints shows acute arthritis.
- The goals of treatment are mainly to stop the pain and inflammation associated with the initial attack, and to prevent future attacks.
Alternative names
Gouty arthritis - acute; Gout - acute
Definition
Acute gouty arthritis is an attack of a metabolic disease marked by uric acid deposits in the joints. The disorder causes painful arthritis, especially in the joints of the feet and legs.
Causes, incidence, and risk factors
Gout is caused by a defect in metabolism that results in an overproduction of uric acid, or a reduced ability of the kidney to eliminate uric acid. The exact cause of the metabolic defect is unknown. The condition may also develop in people with diabetes, obesity, sickle cell anemia, and kidney disease, or it may follow drug therapy that interferes with uric acid excretion.
Gout has 4 stages: asymptomatic (without symptoms), acute, intercritical, and chronic.
In acute gouty arthritis, symptoms develop suddenly and usually involve only one or a few joints. The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating. The joint appears infected with signs of warmth, redness, and tenderness.
The attacks of painful joints may subside in several days, but may recur at irregular intervals. Subsequent attacks usually have a longer duration. Some people may progress to chronic gouty arthritis, while others may have no further attacks.
The risk is greater in men, postmenopausal women, and people who use alcohol.
Symptoms
- Joint pain
o Begins suddenly
o Affects one or more joints (hip pain, knee pain, ankle pain, foot pain, shoulder pain, elbow pain, wrist pain, hand pain, or pain in other joints)
o The great toe, knee, or ankle joints are most often affected - Joint swelling of the affected joints
- Stiffness of the joint
- The joint may be warm and red
- Fever may be present
- Skin lump which may drain chalky material
Signs and tests
A physical examination of the joints shows acute arthritis.
- Synovial fluid analysis shows uric acid crystals.
- Uric acid (blood test) may be elevated.
- Joint X-rays may be normal.
The following tests might also be helpful:
- Uric acid - urine
Frequently asked questions
What is acute gouty arthritis?
Acute gouty arthritis is an attack of a metabolic disease marked by uric acid deposits in the joints. The disorder causes painful arthritis, especially in the joints of the feet and legs.
What are the risk factors for acute gouty arthritis?
Gout is caused by a defect in metabolism that results in an overproduction of uric acid, or a reduced ability of the kidney to eliminate uric acid. The exact cause of the metabolic defect is unknown. The condition may also develop in people with diabetes, obesity, sickle cell anemia, and kidney disease, or it may follow drug therapy that interferes with uric acid excretion. Gout has 4 stages: asymptomatic (without symptoms), acute, intercritical, and chronic. In acute gouty arthritis, symptoms develop suddenly and usually involve only one or a few joints. The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating.
What are the symptoms of acute gouty arthritis?
- Joint pain o Begins suddenly o Affects one or more joints (hip pain, knee pain, ankle pain, foot pain, shoulder pain, elbow pain, wrist pain, hand pain, or pain in other joints) o The great toe, knee, or ankle joints are most often affected
- Joint swelling of the affected joints
- Stiffness of the joint
- The joint may be warm and red
- Fever may be present
- Skin lump which may drain chalky material Signs and tests A physical examination of the joints shows acute arthritis.
- Synovial fluid analysis shows uric acid crystals.
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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