Published: 18 Jun 2025

ICD9: 274.9      ICD10: M10.9      ICD11: FA25

Gout, also known as gouty arthritis, is a common and complex form of arthritis characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe.


Here's a breakdown of the key elements:

What it is:

Arthritis: Inflammation of one or more joints.
Gout: A specific type of arthritis caused by the buildup of uric acid crystals in the joints.

Cause:

Hyperuricemia: The root cause is high levels of uric acid in the blood. Uric acid is a waste product created when the body breaks down purines (found naturally in your body and in certain foods).
Uric Acid Crystals: When uric acid levels are too high, the uric acid can form sharp, needle-like crystals in the joints and surrounding tissues. These crystals trigger inflammation and intense pain.

Symptoms:

Sudden, severe joint pain: Often in the big toe, but can also affect other joints like ankles, knees, elbows, wrists, and fingers.
Swelling: The affected joint becomes swollen and inflamed.
Redness: The skin around the joint may appear red or purplish.
Tenderness: Even light touch to the joint can be excruciatingly painful.
Warmth: The affected joint may feel warm to the touch.
Limited range of motion: Difficulty moving the affected joint.

Risk factors:

Diet: Eating a diet rich in purines (red meat, organ meats, seafood, alcohol, sugary drinks) can increase uric acid levels.
Obesity: Being overweight increases uric acid production.
Medical conditions: Certain conditions like high blood pressure, diabetes, kidney disease, and metabolic syndrome are associated with gout.
Medications: Some medications, such as diuretics (water pills), can increase uric acid levels.
Family history: Gout tends to run in families.
Sex and Age: Gout is more common in men, particularly after age 30. In women, it's more common after menopause.

Diagnosis:

Joint fluid test: A sample of fluid is taken from the affected joint and examined under a microscope for uric acid crystals.
Blood test: Measures the level of uric acid in the blood. However, some people with high uric acid levels never develop gout, and some people with gout have normal uric acid levels.
X-rays: Can help rule out other causes of joint pain.
Ultrasound or CT scans: Can detect uric acid crystals even when they are not visible on x-rays.

Treatment:

The goals of treatment are to relieve pain and inflammation during acute attacks and to prevent future attacks by lowering uric acid levels.

Medications for acute attacks:
Nonsteroidal anti-inflammatory drugs (NSAIDs): Help reduce pain and inflammation.
Colchicine: Effective in reducing pain and inflammation, especially when taken soon after an attack begins.
Corticosteroids: Can be taken orally or injected into the joint to reduce inflammation.
Medications to lower uric acid levels:
Allopurinol: Reduces the production of uric acid.
Febuxostat: Also reduces the production of uric acid.
Probenecid: Helps the kidneys remove uric acid from the body.

Lifestyle Changes:

Dietary changes: Limit purine-rich foods, reduce alcohol consumption (especially beer), and avoid sugary drinks.
Weight loss: If overweight or obese, losing weight can help lower uric acid levels.
Hydration: Drink plenty of water to help the kidneys flush out uric acid.
Limit alcohol: Alcohol can interfere with the removal of uric acid from the body.
Avoid sugary drinks: Fructose-sweetened beverages are associated with increased risk of gout.

Complications:

If left untreated, gout can lead to:

Recurrent gout attacks: More frequent and severe attacks.
Tophi: Deposits of uric acid crystals that form under the skin around joints and other tissues.
Joint damage: Permanent damage to the joints.
Kidney stones: Uric acid crystals can form kidney stones.
Kidney disease: Gout can contribute to the development of chronic kidney disease.

In summary, Gout (Gouty Arthritis) is a painful condition caused by hyperuricemia leading to the formation of uric acid crystals in the joints. It's important to consult a doctor for diagnosis and treatment to manage the condition and prevent complications.