Gout is characterized by excessive uric acid levels in blood and deposition of sodium monourate crystals in the joint and subcutaneous tissues (tophi). The deposition of urate crystals and reaction with the white blood cells (phagocytes) incites the release of inflammatory mediators, which cause the characteristic pain and inflammation.
During an acute attack, the involved joint is red, inflamed and tender. The site of predilection is the 1st Meta-tarso-phalangeal joint of the great toe. However, in late stages other joints may be affected, particularly knee and ankle. Besides, there may be tophi deposition around elbow, or toes.
Treatment of an acute attack is primarily NSAIDs like Ibuprofen, Naproxen etc. Corticosteroids may be used orally or injected into the inflamed joint, provided there are no signs of infection. Another drug used to control acute attacks is Colchicine; use limited due to incidence of diarrhoea. For chronic attacks, the frequency may be reduced using Colchicine or other drugs like Probenecid and Allopurinol.
Another condition that sometimes mimics Gout, is Pseudogout.
The latter is characterized by deposition of CPPD crystals in the joints; and primarily involves the knee.
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