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What are the symptoms of gout?

Urate crystals cause inflammation, meaning the affected joint becomes:

  • intensely painful
  • red
  • hot
  • swollen.

The skin over the affected joint often appears shiny and may peel.

Attacks typically affect the big toe and usually start at night. The symptoms develop quickly and are at their worst within 12-24 hours of first noticing anything is wrong.

Any light contact with the affected joint is painful – even the weight of a bedsheet or wearing a sock can be unbearable.

Gout most often causes symptoms in the big toe, but other joints which may also be affected include:

  • joints in the feet
  • ankles
  • knees
  • elbows
  • wrists
  • fingers.

If several joints are inflamed at once this is called polyarticular gout. It’s very rare to have gout in joints towards the centre of the body such as the spine, shoulders or hips.

Gout affecting the big toe

Urate crystals can also collect outside the joints and may even be seen under the skin, where they form small, firm white lumps called tophi. These aren’t usually painful but sometimes they break down and discharge pus-like fluid containing gritty white material – the urate crystals themselves.

Tophi

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