Empeiria

Gout

Clinically: Gout · also gouty arthritis, high uric acid, urate crystals

metabolic ICD-10 M10.9 MONDO MONDO:0005393 unverified
This describes what this condition typically looks like. It is not a diagnosis and cannot tell you whether you have it -- patterns overlap, results vary between labs, and the same numbers mean different things in different people. Note that a normal-looking result does not reliably rule this out -- see the caveats above.

unverified These explanations are written to be easy to read and have not yet been checked against a source. The ranges and measurement notes on this page show theirs.

definition unverified

Urate crystals form in a joint and trigger sudden, severe inflammation. The classic attack is a red, hot, exquisitely painful big toe that comes on overnight.

An inflammatory arthritis in which chronic hyperuricaemia, from overproduction or underexcretion of urate, leads to deposition of monosodium urate crystals in and around joints, triggering flares of acute inflammation; it progresses from asymptomatic hyperuricaemia and crystal deposition to flares, intercritical gout and, later, tophi.

caveats unverified

Urate is often NORMAL during an acute attack, so a normal result does not rule gout out. The diagnosis rests on the clinical picture, and definitively on finding crystals in fluid drawn from the joint.

Urate is often NORMAL during an acute attack, so a normal result does not rule gout out. The diagnosis rests on the clinical picture, and definitively on finding crystals in fluid drawn from the joint.

No clinical version written yet.

How common it is

Affects a few percent of adults, considerably more men than women, and becomes more frequent with age.

The typical lab pattern

Consistent with it

Fits the picture, but not enough on its own.

Urate high — A required item in the 2015 ACR/EULAR classification criteria (a classification tool, not a diagnostic test); a level below 4 mg/dL counts against gout. It is often normal during a flare, so it is best measured away from one.
C-reactive protein high — Raised during a flare. CRP shows inflammation, but not what is causing it.
Estimated glomerular filtration rate low ref ≥ 60 Gout is about five times more common when eGFR is 60 or below, and kidney disease is common in people with gout.

How it usually feels

Frequencies say how often a symptom accompanies this condition — not the other way round. Most people with any of these symptoms do not have this.