Gout

What is it?

Gout is a form of inflammatory arthritis caused by persistently elevated levels of uric acid within the blood, which often leads to frequent episodes of having painful, swollen joints. In the longer term, this can develop into permanently swollen joints with tophi – aggregates of sodium urate monohydrate crystals which are deposited in and around the joints. It can occur in any joint, but most commonly affects the joint at the base of the big toe.

Why does it occur?

Those more at risk of developing gout include patients who are overweight, have high blood pressure and/or diabetes. A diet high in meat and alcohol can also be a contributory factor, and those with underlying kidney problems can also be more susceptible. 

What are the symptoms?

A gout attack often occurs at night, or will come on very suddenly. The affected joint feels extremely painful and will become swollen, red and tender to touch. Any joint can be affected, but it is most common in the big toe.

How is it diagnosed?

Your consultant will carry out a careful clinical examination and take blood samples to look for the presence of uric acid crystals.

How is it treated?

Non-surgical treatment

Anti-inflammatory medicines will be tried in the first instance, together with recommended lifestyle changes, including taking a vitamin C supplement. Other preventative medications, such as Allopurinol, may also be prescribed.

Surgical treatment

If left untreated, recurrent episodes of gout can lead to a destruction of the joint surfaces, joint deformity and soft tissue lesions, which may require surgery to remove tophi or, occasionally, to replace the affected joint.

One Orthopaedics team specialists

Julie Kohls

Consultant Foot & Ankle Surgeon FRCS (Tr & Orth)

Daniela Tonucci

Pain Management Consultant FRCA FFPMRCA

Anthony Hearnden

Consultant Orthopaedic Specialist FRCS (Tr & Orth)

Mike Lemon

Consultant Orthopaedic Knee and Hip Specialist FRCS (Tr & Orth)

Oliver Templeton-Ward

Consultant Orthopaedic
Knee Specialist FRCS (Orth)

Kerry Acton

Consultant Orthopaedic Knee and Hip Surgeon FRCS (Tr & Orth)