Understanding Gout
Gout is a common inflammatory arthritis caused by the buildup of uric acid crystals in joints. It typically presents with sudden, severe pain, swelling, redness, and warmth, most often affecting the joint at the base of the big toe, but it may also involve the ankles, knees, wrists, elbows, or fingers.
The Arthritis Center of Nebraska specializes in gout diagnosis and long-term management, helping patients control flares, lower uric acid levels, and prevent joint damage.
Gout vs. Pseudogout
Gout is sometimes confused with pseudogout (calcium pyrophosphate deposition disease, CPPD) because both can cause sudden, painful joint swelling.
- Gout is caused by uric acid crystals and most commonly affects the big toe. Long-term treatment focuses on lowering uric acid levels to prevent future attacks.
- Pseudogout is caused by calcium pyrophosphate crystals, most often affects the knee, and does not have a crystal-lowering therapy. Treatment focuses on managing inflammation during flares.
Accurate diagnosis—often confirmed by joint fluid analysis—is essential to guide appropriate treatment.
Our Treatment Approach
Gout is highly treatable. Management focuses on:
- Rapid control of acute flares
- Urate-lowering therapy for patients with recurrent attacks or elevated uric acid
- Preventing chronic gout, tophi, and joint damage
- Ongoing monitoring and medication adjustment
With consistent treatment, most patients can achieve long-term disease control.
When to Refer for Gout
Referral to rheumatology is recommended for:
- Recurrent or severe gout attacks
- Unclear diagnosis or suspected pseudogout
- Tophi or chronic gout
- Coexisting kidney disease or complex medical conditions
- Inadequate response or intolerance to initial therapy
Why See a Rheumatologist?
Rheumatologists are trained to:
- Differentiate gout from pseudogout and other inflammatory arthritis
- Confirm diagnosis with crystal analysis when needed
- Safely manage urate-lowering therapy
- Prevent long-term joint damage