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  • Q&A with Australian Health Practitioners

    What are the symptoms of gout?

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    Dr Irwin Lim


    Irwin completed his Rheumatology training in 2003. The majority of his time is spent treating inflammatory arthritis and in particular rheumatoid arthritis and the spondyloarthritis. … View Profile

    The first attack of gout often occurs in the big toe but many other joints can be affected.Patients describe acute pain, redness, swelling and exquisite tenderness of the affected joint developing over a few hours. Sometimes, patients will wake up with this attack.Occasionally, the patient can have fever associated with an attack, and coupled with the very acute inflammation at the joint, it can be quite difficult to differentiate from an infected joint.

    Over years, if the high uric acid levels or hyperuricaemia are not reduced,  the uric acid crystals accumulate into large visible nodules under the skin and around the joints. These are called tophi. Tophi erode the joints resulting in permanent joint deformity and can rupture through the skin and become infected.Uric acid crystals can also collect in the kidneys leading to kidney stones and reduced kidney function. 

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