Gout

Gout is a form of inflammatory arthritis caused by the buildup of uric acid crystals within the joints and soft tissues. It most often presents as sudden, severe pain in a single joint, commonly the big toe, but it can become chronic and affect multiple joints without proper treatment.

At The Medical Group of New Jersey, our rheumatologists provide expert evaluation and individualized care to help control gout attacks and prevent long-term complications.

Symptom Onset & Initial Evaluation

Gout attacks often occur suddenly and are characterized by intense pain. Common features include:

• Severe joint pain with redness, warmth, and swelling, most often in the big toe, foot, ankle, or knee
• Nighttime flares that may wake you from sleep due to throbbing pain
• Recurrent attacks or tophi formation, firm uric acid deposits under the skin in long-standing disease

During your visit, your rheumatologist will review your diet, medications (such as diuretics), kidney function, and family history to identify causes of elevated uric acid and create a personalized management plan.

Diagnosis

Diagnosis focuses on confirming the presence of uric acid crystals and distinguishing gout from other forms of arthritis:

• Joint aspiration: A small sample of joint fluid is analyzed under a microscope to identify monosodium urate crystals, the gold standard for diagnosis.
• Blood testing: Measures serum uric acid levels to assess for hyperuricemia and guide long-term management.
• Imaging studies: Ultrasound or dual-energy CT scans can detect crystal deposits and inflammation, particularly in chronic or complex cases.

Treatment & Ongoing Management

Gout treatment focuses on relieving painful flares and preventing future attacks by keeping uric acid levels in a healthy range. Some of the strategies include:

During acute flares:

• NSAIDs, colchicine, or short courses of corticosteroids may be used to quickly reduce pain, swelling, and inflammation.

For long-term control:

• Urate-lowering medications such as allopurinol or febuxostat help reduce uric acid levels, preventing future attacks and dissolving tophi (crystal deposits).
• Your rheumatologist will monitor your uric acid regularly and adjust medications to reach your target level.

Lifestyle and prevention:

• Staying well-hydrated and limiting alcohol, red meat, and high-purine foods can significantly reduce the risk of flare-ups.
• Maintaining a healthy weight and managing blood pressure or kidney function also supports long-term control.

The rheumatology team at The Medical Group of New Jersey combines medication management, dietary counseling, and preventive care to help patients achieve lasting relief and protect joint health.

Follow-Up & Outlook

With regular follow-up and careful uric acid control, most patients can remain free of painful flares and prevent long-term joint damage. Ongoing monitoring helps ensure medications stay effective and uric acid levels remain within a healthy range, supporting lasting relief and joint protection.