Three days after the acute onset of pain and swelling of the second toe of his right foot, a 63-year-old man seeks medical care. He denies any trauma. The patient takes no medications.
In patients with gout, monosodium urate monohydrate crystals accumulate in tissues and joints; most often, a single joint is affected. The disease can be confused with an acute bacterial infection (cellulitis), but gout does not respond to antibiotics. Rheumatoid arthritis and osteoarthritis are less acute and less painful and usually affect multiple joints.