Gout

Abstract

Gout is an inflammatory arthritis that can be monoarticular or polyarticular. It manifests as an acute, sub-acute or chronic condition and often mimics other medical diseases. It can evolve over time, both in frequency, severity and involved sites. It can co-exist with other medical problems and can be difficult to treat. However, gout is often poorly treated and patients are often poorly educated about the disease process. As a result, patients often have significant impairment in their quality of life and are at risk from complications due to excess use of antiinflammatories in an attempt to quell their pain. There are many myths surrounding both the causes and treatment of gout and, hopefully, this article will help to dispel some of these. At the end of this document, there are some links to sites that may be helpful to both patients and their doctors. The presence of guidelines for the treatment of gout allows goals to be met with a greater chance of treatment success and reduced chance of long-term joint damage.¹ These guidelines highlight the need for regular checking of serum uric levels and adjustment of treatment dosage until the treat-to-target goal is met. Patients often do not realise that gout is an arthritic process and that as such, poor disease control may result in multiple possible poor outcomes. Gout is the result of deposits of monosodium urate (MSU) crystals in joints or other structures.² The crystallisation occurs when the hyperuricaemia exceeds the solubility level (analogous to a dam overflowing with water). This may occur chronically or intermittently. The frequency of acute attacks gradually increases over time.³