This condition is more prevalent in males than females and there is a familial tendency. It is caused by the deposition of sodium urate crystals in joints and tendons,provoking an acute inflammatory response. Risk factors include,obesity,heredity,hyperuricemia and high alcohol intake. Primary gout,the commonest form,occurs almost always in men and is associated with reduced ability to excrete urate or increased urate production.
Secondary gout occurs usually as a consequence of diuretic treatment or kidney failure,both of which reduce urate excretion.
In many cases only one joint is involved(mono arthritis) and it is typically red,hot and extremely painful. The sites most commonly affected are the metatarsophalangeal joint of the big toe and the ankle,knee,wrist and elbow joints. Episodes of arthritis lasting days or weeks are interspersed with periods of remission. After repeated acute attacks,permanent damage may occur with chronic deformity and loss of function of the affected joints. Gout is sometimes complicated by the development of renal calculi.
