gout symptoms

Gout is a clinical disease associated with
hyperuricemia and caused by the deposition of
monosodium urate (MSU) crystals in and
around the tissues, resulting in one or more of
/the following manifestations:
I- Acute gouty arthritis
II - Tophaceous gout
III- Gouty nephropathy
IV- Uric acid stones

Uric Acid, Hyperuricemia, and Gout
• Uric acid (urate) is the end product of purine
degradation in humans
• Hyperuricemia is a serum urate concentration in
excess of urate solubility (>6.8 mg/dL)
— Results from overproduction and'or underexcretion of
uric acid
— Is a common serum abnormality but does not result in gout
without crystal deposition
• Gout is the disease state resulting from deposition of
monosodium urate crystals in tissues

Because uric acid has limited
solubility in bodily fluids,
monosodium urate crystal formation
occurs above the solubility threshold
Urate crystals are deposited
preferentially in and around
peripheral joints in the feet, knees,
hands and elbows, especially those
affected by osteoarthritis

Conditions Influencing the
Deposition of Urate Crystals
• Decreased solubility of urate
- Low temperatures
- Low pH
• Disturbances to the joint or soft tissue
- Trauma or tissue injury or altered connective tissue matrix
• Reabsorption of water resulting in supersaturation
- Lack of joint activity during sleep

> The fundamental aims of pout
treatment.
Improve outcomes by
<3>short-term suppression
4> long-term elimination of gout flares
<z> induce durable resolution of tophi
<3> identify and effectively manage
comorbidities