Chronic gouty arthritis

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Tophi gout in hand

Uric acid crystals

Gout - chronic; Gouty arthritis - chronic

• An attack of chronic gout is similar to an attack of acute gouty arthritis. The symptoms come on suddenly, usually involving only one or a few joints. The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating. The affected joints show signs of warmth, redness, and tenderness. The pain tends to subside within several days. Chronic gout attacks, however, occur more often.
• If several attacks of gout occur each year, this may cause joint deformity and limited motion in affected 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.

There may be a current or previous medical history of acute arthritis in one joint. A physical examination of joints shows arthritis and tophi.

Tests that indicate gouty arthritis include:

• Synovial (joint) fluid analysis that detects uric acid crystals
• Elevated uric acid level
• Joint x-rays which show damage consistent with gouty arthritis

Review Date: 08/02/2005
Reviewed By: Ariel D. Teitel, M.D., M.B.A., Chief, Division of Rheumatology, St. Vincent's Hospital, New York, NY. Review provided by VeriMed Healthcare Network.