VITAL Rheumatology is a Gout Center of Excellence.

Gout is a form of arthritis characterized by sudden, severe attacks of pain, redness, and swelling in the joints, often starting in the big toe. These attacks, known as flares, can occur suddenly and are often intensely painful, sometimes affecting multiple joints at the same time. Gout is caused by an excess of uric acid in the blood, which can form sharp, needle-like crystals in a joint or surrounding tissue, leading to the characteristic pain and inflammation.
Diagnosing gout involves a combination of clinical evaluation, medical history, and laboratory tests. During an acute flare, the affected joint may be red, warm, and extremely tender. We often perform blood tests to measure uric acid levels, although elevated levels alone do not confirm gout. A definitive diagnosis can be made by analyzing joint fluid under a microscope to detect uric acid crystals. Imaging studies, like X-rays or ultrasounds, can also help identify crystal deposits and assess joint damage.
Treatment for gout focuses on addressing acute attacks and preventing future flares. Long-term management includes lifestyle changes such as dietary modifications to avoid high-purine foods, weight management, and limiting alcohol intake. Medications that lower uric acid levels in the blood, like allopurinol or febuxostat, are often important to prevent future flares and reduce the risk of complications. In severe cases, infusion therapy may be necessary to address symptoms in a timely fashion. Regular monitoring and follow-up care are essential to effectively manage gout and maintain a good quality of life.