Gout is a painful form of arthritis and causes pain and swelling in one or more joints. The base of the big toe is the most commonly affected joint. It is a painful inflammation of a joint as a result of buildup of crystals within the joint. The crystals are made of uric acid, a substance that is found in many foods and usually excreted by the kidneys. People, who produce too much uric acid, or whose kidneys do not excrete it enough, are predisposed to the development of gout. When the levels of uric acid in the blood are high enough, it begins to collect as crystals in joints which lead to pain and swelling. Gout most often affects the base of the big toe, but can affect any joint. It tends to recur in repeated attacks of acute inflammation.
The diagnosis of gout is often suggested on the basis of the history and physical exam. A sample of joint fluid can be obtained with a needle and examined under a microscope. The urate crystals can then be seen. This is also the best way to make sure the joint is not infected, or inflamed due to another condition.
Acute attacks of gout are often treated with anti-inflammatory medications, which are taken daily to decrease the level of uric acid to help prevent attacks of gout.
Repeated attacks of gout tend to last longer, and the pain may not go away entirely. Eventually the bones of the joint can be damaged, and large collections of urate crystals can accumulate under the skin and cause nodules.