Acute Gouty Arthritis
Acute gouty arthritis is a sudden, intensely painful inflammatory joint attack caused by urate crystals, often affecting the base of the big toe.
Key takeaways
- A first hot swollen joint should be assessed because joint infection can resemble gout and needs urgent treatment.
- Anti-inflammatory treatment works best when started early, but kidney disease, ulcers and other medicines affect the safest option.
- Long-term urate-lowering therapy prevents future attacks; it is different from medicine used to settle the current flare.
The listings below do not confirm gout or suit every flare; diagnosis and comorbidities should guide treatment.
Recognising a flare
Pain often escalates over hours with redness, warmth, swelling and extreme tenderness. Prior attacks and raised urate support the diagnosis, but a normal urate level during a flare does not exclude gout. Joint-fluid testing may be needed when infection is possible or the diagnosis is uncertain.
Treating now and preventing later
NSAIDs, colchicine or corticosteroids may be used for an acute attack depending on individual risks. People already taking prescribed urate-lowering medicine are usually advised not to stop it during a flare. Prevention also involves reviewing urate levels, triggers and relevant medicines.
When to seek urgent care
Seek urgent assessment for a first hot swollen joint, fever or chills, rapidly spreading redness, inability to bear weight, or severe illness alongside joint pain.