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 the joints. The disease is characterized by bifocal sodium urate crystals found in joint fluid and gout stones. The clinical features are: hyperuricemia and characteristic acute arthritis due to urate crystals and deposition, gout stones, interstitial nephritis, and in severe cases, joint deformity and gouty nephropathy. It is mostly seen in middle-aged and elderly men with obesity and postmenopausal women. With economic development and lifestyle changes, its prevalence is gradually increasing, and the number of “rich people’s diseases” like gout is increasing. A survey in Nanjing in 2003 showed that 13.3% of the patients had hyperuricemia and 1.33% had gout. However, people do not pay enough attention to gout, and the problems encountered in clinical diagnosis and treatment of gout are summarized below. Myth 1: High uric acid is gout, must use drugs We know that gout is a disease caused by high blood uric acid, the daily production and excretion of uric acid is to maintain a certain balance, if overproduction or poor excretion, it will make uric acid accumulate in the body, resulting in excessive uric acid in the blood (i.e. hyperuricemia). Only when there is an attack of gouty arthritis can it be called gout, while those who have never had an attack of arthritis are called hyperuricemia. As long as you pay attention to your diet or find out the cause of correction, the uric acid value may return to normal and usually does not require medication, while gout is a disease state that if left untreated usually results in the appearance of gouty stones and even leads to joint deformity, which can lead to renal insufficiency in late stages. Myth 2: Blood uric acid must be high during a gout attack According to statistics, about 30% of people with gout are within the normal range of blood uric acid values during an acute arthritis attack, but as long as they continue to follow up on the uric acid values, most of them will be found to be high. On the other hand, people with high uric acid in their blood may not necessarily have gout if they have joint pain, so they should consult a physician to avoid misdiagnosis and treatment. In addition, uric acid is a dynamic balance in the body, and the value of uric acid may be different every day, so it should be measured several times to determine if it is really too high. Myth 3: Controlling a high purine diet can prevent gout and its recurrence Diet is indeed an important factor in triggering gout attacks. Domestic statistics report that gout triggers are, in order of prevalence, excessive fatigue, consumption of high purine foods, alcoholism, colds, joint trauma and excessive exercise. However, we should also pay attention to several factors that are closely related to gout attack, such as obesity, combination of other diseases, especially hypertension, hyperlipidemia, and the application of low-dose aspirin and thiazide diuretics. Some data show that more than 50% of gout patients are overweight and about 3/4 have hypertension or (and) hyperlipidemia in combination. Therefore, it is not enough to control the diet alone, but it is especially important to reduce weight, treat concurrent diseases and avoid diuretics. Myth 4: Uric acid-lowering drugs should be used immediately when gout attacks occur. When gout occurs acutely, uric acid-lowering drugs cannot control joint inflammation, instead, because they lower the blood uric acid level, the crystals formed by dissolving gout stones in the joints can aggravate joint inflammation or (and) cause metastatic gout. Therefore, we should wait until the acute inflammation is controlled before using uric acid-lowering drugs. Gout Lixian (Ligarixen, benzbromarone) is a uric acid-lowering drug, and its use during the acute gout attack will aggravate the pain of gout. Myth 5: Gout attacks require anti-infection treatment Gout is a sterile inflammatory reaction caused by uric acid crystals deposited in the joints and surrounding tissues, unless there is a co-infection, generally do not need to use antibiotic treatment, some antibiotic use can also raise blood uric acid, aggravating gout. Myth 6: Gout is an acute disease, redness, swelling and pain will not need to be treated In fact, gout is a chronic disease like diabetes, a few only once or a few times, most frequent attacks. Although you don’t need to take medication for life like most diabetic patients, you should follow up for a long time and review regularly. In particular, some patients with stubborn recurrent attacks, combined with gout stones, chronic kidney disease, high blood lipids, high blood pressure, high blood sugar, need a long time to regulate the use of drugs, otherwise it is easy to develop joint deformity and renal insufficiency.