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Definition[edit]

Gout is a form of inflammatory arthritis characterized by recurrent attacks of a single red, tender, hot, and swollen joint.[1][2]

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Symptoms[edit]

Pain typically comes on rapidly, reaching maximal intensity in less than twelve hours.[3] The joint at the base of the big toe is affected in half of cases.[4]

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It may also result in tophi, kidney stones, or urate nephropathy.[3]

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Cause[edit]

Gout is due to persistently elevated levels of uric acid in the blood.[3][2]

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This occurs from a combination of diet, other health problems, and genetic factors.[3][2] At high levels, uric acid crystallizes and the crystals deposit in joints, tendons, and surrounding tissues, resulting in an attack of gout.[3]

A self-indulgent man afflicted with gout; the pain is represented by a demon burning his foot Wellcome V0010850.jpg

Gout occurs more commonly in those who regularly eat meat or seafood, drink beer, or are overweight.[3][5]

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Diagnosis[edit]

Diagnosis of gout may be confirmed by the presence of crystals in the joint fluid or in a deposit outside the joint.[3] Blood uric acid levels may be normal during an attack.[3]

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Treatment[edit]

Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine improves symptoms.[3][2][6]

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Prevention[edit]

Once the acute attack subsides, levels of uric acid can be lowered via lifestyle changes or allopurinol.[3] Taking vitamin C and eating a diet high in low-fat dairy products may be preventive.[7]

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Epidemiology[edit]

Gout affects about 1 to 2% of the Western population at some point in their lives.[3] It has become more common in recent decades.[3]

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Older males are most commonly affected.[3]

A man with gout seated at a table drinking with a parson and Wellcome V0010857.jpg

History[edit]

Gout was historically known as "the disease of kings" or "rich man's disease"[3][8] and has been recognized since at least the time of the ancient Egyptians.[3]

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References[edit]

  1. ^ Chen LX, Schumacher HR (October 2008). "Gout: an evidence-based review". J Clin Rheumatol. 14 (5 Suppl): S55–62. doi:10.1097/RHU.0b013e3181896921. PMID 18830092.
  2. ^ a b c d Hui, M; Carr, A; Cameron, S; Davenport, G; Doherty, M; Forrester, H; Jenkins, W; Jordan, KM; Mallen, CD; McDonald, TM; Nuki, G; Pywell, A; Zhang, W; Roddy, E; British Society for Rheumatology Standards, Audit and Guidelines Working, Group. (26 May 2017). "The British Society for Rheumatology Guideline for the Management of Gout". Rheumatology (Oxford, England). 56 (7): e1–e20. doi:10.1093/rheumatology/kex156. PMID 28549177.
  3. ^ a b c d e f g h i j k l m n o Richette P, Bardin T (January 2010). "Gout". Lancet. 375 (9711): 318–28. doi:10.1016/S0140-6736(09)60883-7. PMID 19692116.
  4. ^ Schlesinger N (March 2010). "Diagnosing and treating gout: a review to aid primary care physicians". Postgrad Med. 122 (2): 157–61. doi:10.3810/pgm.2010.03.2133. PMID 20203467.
  5. ^ Beyl Jr, R. N.; Hughes, L; Morgan, S (2016). "Update on Importance of Diet in Gout". The American Journal of Medicine. 129 (11): 1153–1158. doi:10.1016/j.amjmed.2016.06.040. PMID 27452679.
  6. ^ Shekelle, P. G; Newberry, S. J; Fitzgerald, J. D; Motala, A; O'Hanlon, C. E; Tariq, A; Okunogbe, A; Han, D; Shanman, R (2017). "Management of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice Guideline". Annals of Internal Medicine. 166 (1): 37–51. doi:10.7326/M16-0461. PMID 27802478.
  7. ^ "Questions and Answers about Gout". National Institute of Arthritis and Musculoskeletal and Skin Diseases. June 2015. Archived from the original on 15 January 2016. Retrieved 2 February 2016.
  8. ^ "Rich Man's Disease – definition of Rich Man's Disease in the Medical dictionary". Free Online Medical Dictionary, Thesaurus and Encyclopedia.