A common and very treatable form of inflammatory arthritis, caused by crystals forming in the joints
Gout is one of the most common forms of inflammatory arthritis. It happens when urate crystals build up in a joint, triggering sudden, intense inflammation. Although a flare can be extremely painful, gout is very treatable, and with the right approach future attacks can often be prevented.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928).
A gout flare often comes on quickly, sometimes overnight. Typical features include:
Gout can usually be recognised from the pattern of symptoms, supported by blood tests and, where needed, examination of fluid from the joint. It is worth confirming the diagnosis, because several other conditions can look similar.
Ultrasound is a useful tool here. It can show features that suggest urate crystals in and around the joint, helping distinguish gout from other causes of a hot, swollen joint. As Dr Borukhson uses point-of-care ultrasound during the consultation, this can often be assessed in the same visit. Importantly, these crystal features can often be seen on ultrasound even between attacks, when the joint is no longer painful or swollen, so there is no need to wait for a flare before seeking assessment.
Treatment has two parts: settling an acute flare, and, where appropriate, reducing the urate level over the longer term to prevent further attacks and protect the joints. Both are discussed with you and tailored to your circumstances.
Lifestyle factors can play a part, and longer-term medication to lower urate is often very effective when it is needed. Where a single joint is severely inflamed, an ultrasound-guided injection may help bring it under control. The right plan depends on your individual situation and is agreed together.
Recurrent gout is not something to simply endure. With an accurate diagnosis and the right long-term approach, attacks can often be prevented and the joints protected. If you have had a hot, painful, swollen joint, a specialist review can confirm the cause and set out a clear plan.
A specialist assessment, with ultrasound where helpful, can confirm whether it is gout and agree a plan to prevent future flares
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