What Are the Symptoms of Gout?

05.26.2008 by Dr John Anne in Health Care

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What is Gout?

Gout occurs when too much uric acid builds up in the blood and uric acid crystals precipitate in the cooler parts of the body such as the joints of the hands or feet. High levels of uric acid may also build up as lumps under the skin called tophi, or as kidney stones. Uric Acid is a waste product of the oxidation of purines which are constituents of nucleic acids such as DNA. Uric acid is normally excreted in the urine to maintain a concentration of uric acid in the blood of approximately 4 mg/dL. When the concentration exceeds 7 mg/dL, crystals of monosodium urate start to form in the tissues. This condition is known as hyperuricemia.Signs and Symptoms of Gout

Although 90% of people with gout have an attack in their big toe, other joints affected may be the instep, ankle, knee, wrist, and fingers. The arthritis symptoms usually come without warning, but some people have minor pain in the ankle, soreness in the heel, or twinges of pain in the big toe before the attack.

If several attacks of gout occur each year, it can lead to joint deformity and limited motion in joints. Uric acid deposits called tophi develop in cartilage tissue, tendons, and soft tissues. These tophi usually develop only after a patient has suffered from the disease for many years. Deposits also can occur in the kidneys, leading to chronic kidney failure.

The big toe is the most common gout symptom. Other joints affected include the ankles, insteap, heel, foot, hand, knees, wrists, fingers, and elbows. The most common gout symptoms are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness, fever. People usually have ‘attacks’ of gout - it may affect you for a period of time and then go away eventually, even without treatment.

The first attack of gouty arthritis usually involves only one joint, most commonly the big toe. However, it sometimes affects a knee, ankle, wrist, foot or finger. In gouty arthritis, the joint can become red, swollen and extremely tender to the touch. Typically, even a bed sheet brushing against the joint will trigger intense pain. After the first attack of gout, later episodes are more likely to involve several joints. Sometimes, if gout lasts for many years, uric acid crystals can collect in the joints or tendons, under the skin or on the outside the ears, forming a whitish deposit called a tophus.

Uric acid in normal amounts remains dissolved in the blood and easily passes through the kidneys, leaving the body as waste. However, uric acid in high amounts makes a person more likely to develop symptoms of gout .