- Precipitation of monosodium urate crystals in joint space
- Male, > 50, prior hx gout, etoh, hypertension, obesity, CKD
- High purine foods→ fish, red meat, diuretics
- Relatively common (~20/1000)
- Acutely red, warm, painful joint
- Typically one joint but can be polyarticular
- Most common great toes and smaller joints; but can affect any
- Can also have uric acid kidney stones--> acute flank pain, hematuria
- Warmth and redness of affected joints
- Rarely tophi if profound and persistent hyperuricemia
- Aspiration of joint fluid reveals negatively birefringent, needle-shaped crystals
- Joint fluid also w/2k-50k wbcs, no organisms
- Serum uric acid level > 6 (though most w/elevated uric acid dont develop gout)