Gout is a form of arthritis that usually starts in the big toe.


Gout is a form of arthritis characterized by sudden, severe flares of pain, inflammation, swelling, redness and tenderness in the joints.

Although gout can affect any joint, it is most common in the big toe, often affecting the joint at the base of the toe. Other common locations include the knees, ankles, elbows, wrists and fingers.

An attack of gout can occur suddenly and often wakes patients in the middle of the night with a sensation of their joint being on fire. The affected joint is hot to the touch, swollen and so tender that any weight on it can feel unbearable, even the weight of the bed sheet.

What Causes Gout?

Purines are a group of chemicals found in body tissues and also in many foods. The body must continually process purines by breaking them down and recycling them or removing the byproducts, such as uric acid. Uric acid normally dissolves in the blood, passes through the kidneys, then exits the body in urine.

In some people, the body produces too much uric acid, or the kidneys do not excrete enough of the uric acid buildup. Sharp, needlelike urate crystals form from this excess uric acid, which then accumulates in a joint leading to inflammation and an attack of gout.How gout forms

High concentrations of uric acid levels in the blood (hyperuricemia) are necessary for the urate crystals to form; however, their presence does not necessarily indicate that gout will develop. For unknown reasons, some people with hyperuricemia do not develop gout, or they develop it after many years of retaining high uric acid levels.

Hyperuricemia affects approximately 23 to 24 million Americans, but only 8 million of these patients will actually develop gout. Hyperuricemia alone is not usually treated, though lifestyle changes may be suggested in attempt to prevent future gout.

What Are the Risk Factors for Gout?
Risk factors that increase the body