Gout and Gouty Arthritis

Abstract

Gouty arthritis is now largely controllable, but unfortunately it remains the rheumatic disease that is most often missed in diagnosis. Among the reasons it is not recognized more often are a mistaken idea that gout is rare in North America, overdependence on elevated serum uric acid, too much reliance on the presence of tophi, and, most important, failure to consider gout when a patient has an acutely inflamed joint. Features that are helpful in early diagnosis include the speed of onset, severity and duration of the attack, periodicity of attacks, characteristic appearance of the affected joint, and inciting factors.