Gout is the most common form of inflammatory arthritis affecting 8.3 million US adults (3.9% of the US population).
Gout tends to affect men more commonly than women. Gout start to affect women after menopause. While gout is commonly associated with diet, it is primarily due to genetic factors that affect how easily someone can excrete uric acid. Gout often “runs” in families. Uric acid is a breakdown product of DNA. When uric acid levels build up (greater than 6 mg/dL), urate crystals can form and deposit in joints. It is these crystal that cause the very painful gout attacks. Gout most frequently strikes in the big toe, but it can affect any joint. There are many effective medications to treat and control gout. However, these often need to be taken for a long time. Gout is curable, but staying on the daily medication is essential to treating recurrent gout. If you have gout or worried that you might have gout, please consult one of our rheumatologists.
Gout can be diagnosed based on your symptoms, x-rays, and labs. Sometimes your doctor may need to take fluid out of your joint to look for crystals. Some of our Rheumatologists use ultrasound to diagnose gout. UCLA also has dual energy CT scan that are used specifically to diagnose gout.
Most patients with gout do not eliminate enough uric acid through the kidneys. This most often genetic and gout often occurs in families. Diet, obesity, kidney function, and medications can affect the build of uric acid.
The medications that can increase uric acid include diuretics (water pills), low dose aspirin and some transplant medications.
Diets rich in purine (found in red meat, shellfish, legumes or organ meats) can increase uric acid levels. Sugary drinks that include fructose or alcoholic drinks, particularly beer, can also increase uric acid levels.
Obesity increases the risk of gout. Gout patients often also have high blood pressure, diabetes, and high cholesterol. We are investigating the link between gout and cholesterol. Please see the research section.
Gout can be diagnosed by clinical history and exam or by analyzing fluid taken from a joint for crystals. This is commonly done with a traditional polarized light microscope. Here at UCLA, we are developing a new lens-free polarized microscope to improve detection of gout and pseudogout crystals. (See our Gout Research section.)
Gout can also be diagnosed by ultrasound or a specialized gout CT scan (dual energy CT – DECT scan). Both Ultrasound and DECT are available at UCLA.