Gout is one of the most common forms of inflammatory arthritis and can cause extreme pain, joint swelling, warmth, and redness. About half of gout cases affect the big toe joint (metatarsophalangeal joint), while the remaining cases typically affect other joints in the foot as well as the knee, elbow, wrist, and fingertips.1

While there are several known triggers for an episode of gout, symptoms can also occur suddenly and without warning, often flaring up in the middle of the night. A gout episode can last for a few days or even weeks with the worst pain usually occurring in the first day or two.


Centuries ago, gout was nicknamed the "king’s disease" or "rich man's disease" because eating meat and drinking alcohol were known to bring on a gout flare-up. Despite its reputation, gout can affect anyone: the estimated number of Americans who have gout ranges from 3 to 6 million.2,3,4Another common term for gout is "gouty arthritis."

Experts do not completely understand why some people get gout and others do not, but the risk factors, diagnosis and treatment for gout are well established.

In This Article:

What is Gout?

Gout results from a build-up of uric acid crystals (monosodium urate crystals) in a joint. These needle-like, microscopic crystals collect in the soft tissue of the joint, causing pain that can be excruciating, as well as swelling, redness, and warmth.

The build-up of uric acid crystals begins with purines, a chemical compound found in many foods. When the body metabolizes purines it produces a substance called uric acid, which is delivered to the bloodstream. The uric acid is then filtered out by the kidneys and excreted via urine (70%) or stool (30%). 5

See What Are Purines?

Too much uric acid in the bloodstream is called hyperuricemia. In some people, the excess uric acid forms crystals that collect in the joints, resulting in gout.

Read more about Hyperuricemia - High Uric Acid Levels and Gout

Purines found in foods are metabolized by the body and turned into uric acid.1 Uric acid is normally filtered out of the bloodstream by the kidneys.2 Excess uric acid in the bloodstream can lead to the formation of uric acid crystals in one or more joints, resulting in gout.3


An inability to adequately process and excrete uric acid accounts for an estimated 80 to 90% of gout cases.6

Left untreated, a gout episode will usually resolve itself within a few days or weeks. Repeated instances of gout are called chronic gout, which can permanently damage a joint over time, resulting in decreased range of motion and other problems. For this reason, it is important to diagnose, treat and prevent gout as early as possible.


  1. Center for Disease Control and Prevention. Arthritis: Gout.
  2. Emilio B. Gonzalez, An update on the pathology and clinical management of gouty arthritis.
  3. Kramer HM, Curhan G. The association between gout and nephrolithiasis: the National Health and Nutrition Examination Survey III, 1988–1994.

Complete Listing of References

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