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VITAL Rheumatology is a Gout Center of Excellence.
Expertise
Our providers are experiences in all aspects of gout, including advanced diagnostic imaging with dual-energy CT (DECT) and laboratory testing.
Comprehensive Care
Our clinic offers lifestyle, dietary counseling in addition to oral medications and infusions such as pegloticase.
Education
Our team provides extensive counseling and educational material about the disease and its treatments.
Gout: Diagnosis & Treatment
Gout is a form of arthritis caused by excess uric acid in the blood, leading to sudden, severe attacks of joint pain and inflammation
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.
Gout FAQ
What causes gout?
Gout is caused by a buildup of uric acid in the blood, which can form crystals in the joints. This buildup can happen if the body makes too much uric acid or doesn’t get rid of enough of it. Certain foods, alcohol, obesity, and some medical conditions can raise uric acid levels.
How is gout treated?
Gout flares are treated with medications that reduce inflammation, like NSAIDs, colchicine, or corticosteroids. Long-term medications like allopurinol or febuxostat lower uric acid levels to prevent future attacks. Krystexxa infusions provide fast results in individuals with advanced disease or if their gout is resistant to usual therapies. Lifestyle changes, like diet and weight management, also help prevent flares.
What kind of diet can prevent gout flares?
To prevent gout flares, it's best to avoid foods high in purines like red meat, shellfish, and sugary drinks. Limiting alcohol, especially beer, can also help. A diet with more fruits, vegetables, whole grains, and low-fat dairy is recommended.
What joints are most commonly affected in gout?
Gout most commonly affects the big toe, but it can also occur in other joints like the ankles, knees, wrists, and fingers. The pain is often sudden and severe, with swelling and redness in the affected joint.
What are tophi?
A single tophus or multiple tophi, are hard lumps of uric acid crystals that form under the skin in people with chronic gout. They usually appear around the elbows, the fingers, the ears, or the feet. Tophi can be painful and may permanently damage the joints if not treated.
What is the difference between gout and bunions?
Gout is a type of arthritis caused by uric acid buildup, leading to sudden joint pain and swelling, often in the big toe. A bunion is a bony bump that forms on the joint at the base of the big toe, usually due to wear-and-tear, or osteoarthritis. Gout involves inflammation, while a bunion is a structural problem with the bone.
Is gout life-threatening?
Gout itself is not life-threatening, but if it’s not managed, it can lead to serious complications like joint damage or kidney problems. Rarely, severe gout can cause kidney stones or contribute to other health issues. Proper treatment helps prevent these complications.
Is there an infusion that treats gout?
Yes, an infusion called pegloticase (Krystexxa) can treat severe or difficult-to-control gout providing rapid improvement. Pegloticase lowers uric acid levels by breaking down uric acid in the blood. These infusions are provided at VITAL Rheumatology.
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