Gout

Gout is a common type of inflammatory arthritis affecting about 1% of the population. It typically affects males over the age of 40 and women over the age of 65. Gout is also considered a metabolic disorder which causes uric acid to accumulate in blood and tissues.

A number of dietary and lifestyle factors can contribute the accumulation of uric acid. The joint synovium, cartilage, and bone become supersaturated and the urate salts form needle like crystals within the joint. Once the crystals have formed, there is an inflammatory response within the synovium and tissues resulting in a very hot, swollen and reddened joint.

Gout causes a rapid onset of synovial joint inflammation, swelling, and redness. Joint discomfort can last from days to weeks after the most severe pain subsides. Gout is a monoarticular or single joint problem, however if poorly managed can involve more than one joint (polyarticular).

The most common locations are gout in the big toe, followed by gout in the knee, gout in the ankle, and gout in the midfoot. Gout less commonly affects the hands and elbow and rarely affects the spine, hips and shoulders.

The important features to discriminate between gout and osteoarthritis is the sudden onset and the presence of severe pain and synovial joint swelling. Moreover, the important features to discriminate between gout and rheumatoid arthritis (RA) is rapid onset but more importantly gout is monoarticular where RA is polyarticular.