Gout is a joint disease caused by an abundance of uric acid in the blood. Uric acid is a waste product that our body usually eliminates. If, however, there is decreased excretion or increased production of this metabolite it predisposes individuals to gout. Uric acid turns into a crystal form known as monosodium urate which can deposit anywhere in the body. Most often the crystals deposit in the joints which causes localized inflammation. Resultant symptoms of severe pain are experienced by the patient along with redness and swelling of the involved area. The classical site affected by gout is the big toe, but attacks can affect other joints as well.
Gout is one of the oldest forms of arthritis in recorded history. Gout has been referred to as “rich man’s disease” because of its association with eating meat – an item usually consumed by the wealthy in historical times. Both King Henry VIII of England and King Charles I of Spain are said to have been afflicted by gouty arthritis.
Gout is characterized by symptoms of pain that start suddenly and eventually diminish, even in the absence of treatment. Between the flares of pain, the affected joint will be symptom-free. The affected joint space and the tissues surrounding it are swollen, red, and feel warm to the touch. A variety of symptoms can result depending on where in the body the monosodium urate crystals settle. A collection of crystals can form a mass known as a tophus and deposit in soft tissue including that of the skin where it feels like a fixed bump. Similarly, this can happen in cartilage and frequently involves the ear. High levels of uric acid can also put individuals at risk of forming kidney stones in which case the patient would present with bouts of severe abdominal pain.