Gout is the most common type of inflammatory arthritis and typically presents from 30 years of age onwards, more commonly in males. The disease arises due to an excessive level of uric acid in the blood, which is filtered into synovial joints where it can cause a local inflammatory response in susceptible individuals. This can cause considerable pain and if left untreated can cause damage to joints that can lead to secondary osteoarthritis.
It is important to consider the causes of the condition and carefully control the levels of uric acid in the blood when managing gout, as any disruption to urate homeostasis will precipitate an acute attack of gout. If symptoms occur, treatment generally revolves around reducing inflammation with a non-steroidal anti-inflammatory (in patients who are not contraindicated to this type of medication) and colchicine can also be prescribed to target the neutrophilic response associated with gout. Allopurinol is a life-long treatment which reduces uric acid synthesis in the first place, but is not the first line of treatment as it can worsen symptoms if prescribed in the absence of an NSAID and/or colchicine.
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