Gout (gout) is a recurrent inflammatory disease caused by increased purine biosynthesis, excessive uric acid production or poor uric acid excretion resulting in elevated uric acid in the blood and deposition of urate crystals in synovial membranes, bursae, cartilage and other tissues. The disease is characterized by bifocal monohydrate uric acid crystals found in joint fluid and gout stones. Its clinical features are: hyperuricemia and urate crystals, characteristic acute arthritis due to deposition, gout stones, interstitial nephritis, and in severe cases, joint deformity and dysfunction, often accompanied by uric acid urinary tract stones, most often seen in middle-aged and elderly men with obesity and postmenopausal women. With economic development and lifestyle changes, its prevalence is gradually increasing. Gout Causes Alcohol consumption (25%): Alcohol consumption can easily trigger gout, because when alcohol is metabolized in liver tissue, a large amount of water is blown away, which strengthens the blood concentration, so that the uric acid, which is already close to saturation, accelerates into the soft tissues to form crystals, causing the body’s immune system to overreact (sensitive) and cause inflammation, and gout is known as the “king’s disease”. For example, Kublai, the founder of the Yuan Dynasty, suffered from gout in his later years due to excessive alcohol consumption. Diet (15%): Gout can be triggered by diet, weather changes such as sudden changes in temperature and pressure, and trauma. Some foods are metabolized, and some of their derivatives can trigger the re-dissolution of uric acid crystals that have accumulated in the soft tissues, which can trigger and aggravate arthritis. Long-term increase of uric acid (15%): Long-term increase of uric acid in the blood is the key cause of gout, and uric acid in the human body mainly comes from two sources: (1) nucleic acid and other purine compounds produced by the metabolism of proteins in human cells, which generate endogenous uric acid by the action of some enzymes. (2) Purine compounds, nucleic acids and nucleoprotein components in food, which are digested and absorbed to produce exogenous uric acid by the action of some enzymes. Typical symptoms: Increased deposition of uric acid in the joints (75%) Fatigue (65%) Rheumatoid nodules (60%) Granulomas (60%) Heavy drinking (55%) Localized tingling in the joints (55%) Acute gouty arthritis can be triggered by mild trauma, excessive consumption of high purine foods or alcohol, surgery, fatigue, emotional stress, and medical emergencies (e.g., infection, vascular obstruction) without any precursors. Acute attacks of gout, often at night, are usually the first symptom of acute uni- or multi-joint pain, which is progressive and severe, with signs similar to those of an acute infection, including swelling, localized heat, redness and marked tenderness. Systemic manifestations include fever, palpitations, chills, malaise, and leukocytosis. The first few attacks usually involve only one joint and usually last only a few days, but later they can affect several joints simultaneously or successively, and if untreated can last for several weeks, and finally the local symptoms and signs subside and joint function is restored, with asymptomatic intervals varying widely and becoming shorter as the disease progresses. In a few cases, the joints of sacroiliac, sternoclavicular or cervical vertebrae can also be involved. Uric acid deposits are common in the mucous capsule walls and tendon sheaths, and enlarged gout stones and chalky uric acid crystals can appear in the hands and feet. 1. Asymptomatic phase Serum urate concentration increases with age, and there are gender differences, this phase is mainly manifested as a continuous or fluctuating increase in blood uric acid, from the increase in blood uric acid to the appearance of symptoms can take years to decades, only when arthritis occurs is called gout. 2. Acute arthritis attack is the most common first symptom of primary gout, which occurs in the joints of the lower limbs, with the bunions and the first metatarsal phalangeal joint being the most common, with inflammation of a single joint in the first attack and more joints being involved in repeated attacks. Gout attacks last for a few days to a few weeks can be spontaneously relieved, without sequelae and complete recovery, and then there is a symptom-free phase, known as the acute attack interval, after which it can recur, about 60% of patients recur within a year, and the interval is also up to more than 10 years. 4. Gout stone and chronic arthritis stage In untreated or poorly treated patients, uric acid crystals are deposited in cartilage, tendons, bursal fluid and soft tissues, and gout stone is a common manifestation of this stage, often occurring in the ear wheel, forearm extension, metatarsal toes, fingers, elbows, etc. The deposition of uric acid in the joints increases, and the inflammation repeatedly enters the chronic stage and does not disappear completely, causing bone erosion defects in the joints and surrounding tissue Fibrosis, which causes stiffness and deformity of the joint and restriction of movement. With repeated attacks of inflammation, the lesion becomes more and more aggravated and seriously affects the function of the joint, and with early prevention and treatment of hyperuricemia, the patient can be free of this stage.