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Arthritis and Gout

Gout is a form of arthritis -- an inflammation of the joints -- that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling in some joints. It usually affects one joint at a time, although it can be in several joints at once.

The large toe is most often affected, but gout can also affect other joints in the leg -- such as the knee, ankle, and foot -- and less often, the hand, wrist, fingers, and elbow. The spine is almost never affected.

What Are the Symptoms of Gout?

The symptoms of gout include:

  • Sudden, intense joint pain, which often can wake a person from sleep
  • Swollen joint that is warm to touch
  • Red or purple skin around the joint

If someone has gout on and off for years, eventually uric acid crystals may accumulate in the body to form gritty nodules called "tophi." These nodules can appear as lumps under the skin near joints such as the elbows and fingers, at the rim of the ears, or in the kidneys.

Uric acid comes from purines, which are the natural breakdown products of the genetic material in cells, RNA (ribonucleic acid) and DNA (deoxyribonucleic acid). Some foods contain large amounts of purines, especially red meats and organ meats (such as liver and kidneys), as well as some shellfish, anchovies, and alcohol. Purines are broken down to uric acid in the body.

Uric acid in normal amounts remains dissolved in the blood and easily passes through the kidneys, leaving the body through the urine as waste. However, uric acid in high amounts makes a person more likely to develop gout. That's because the uric acid can form into crystals in higher amounts. Gout crystals act like ground glass in the joint, causing significant pain and joint destruction as well as possible kidney damage.

The amount of uric acid in your blood can change depending on what you eat and drink, how hydrated or dehydrated you are, your overall health, how much alcohol you drink, and the medicines you are taking. It can change in response to a sudden illness.


What Causes Gout?

Gout results from abnormal deposits of uric acid crystals in the joint cartilage. The crystals are later released into the joint fluid.

Gout was once incorrectly thought to be a disease of only the rich and famous, caused by consuming too much rich food and fine wine. Although diet and excessive drinking contribute to gout, they are not the main cause of the condition. We now know that heredity plays a role in the development of gout, and it's often associated with other medical problems like high blood pressure.

Not everyone with high levels of uric acid will develop gout. The kidneys' ability to rid the body of uric acid is partly determined by heredity. And just because someone in the family suffers from gout does not mean everyone in that family will have the disease. This risk varies from person to person.

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