Gout is a form of arthritis. It is actually considered the most painful form of arthritis. It occurs when too much uric acid builds up in the body, also known as high uric acid concentration. When your body has too much uric acid, it can disrupt homeostasis, affecting toes, wrists, elbows and other parts of the body that may be affected by gout. Uric acid is hydrogen with the formula C5H4N403. It forms ions and salts known as urates and acid urates such as ammonium acid urate. Uric acid is a product of the metabolic degradation of purines and nucleotides. The metabolic disorder called hyperuicemia, which leads to the deposition of monosodium uric acid in the blood. Gout is also associated with an increased risk of kidney stones. For many people, the first attack of gout occurs in the big toe. The tip will be very sore, appear red and swollen. Gout can also affect the ankles, heels, knees, wrists, fingers and elbows. This form of arthritis is especially common in men and is said to be the "king's disease", meaning that only people of a certain wealth were affected by the disease because they could afford foods such as steak and seafood. Risk factors for gout include being overweight or obese, high blood pressure, alcohol intake (beer and spirits more than wine), use of diuretics, and a diet high in meat and fish. It is diagnosed by aspiration and microscopic analysis for urate crystals in the joint fluid. or a tophus, which is a deposit of urate in tissues (such as cartilage) that is characteristic of gout. Urate crystals are negatively birefringent under polarized light. Infection must be excluded. I personally watched the doctor I work with suction a patient's knee to get the... middle of paper......ric acid that can prevent gout attacks. Uloric may be a better choice for select patients than allopurinol because Uloric is metabolized by the liver in addition to being excreted by the kidneys. This allows for the safe use of Uloric in patients with reduced kidney function. Allopurinol is excreted exclusively in the urine and use in patients with moderate to severe renal dysfunction requires particular caution. Uloric with its dual metabolism can be used in patients with more significant kidney disease. The data presented by the manufacturer states that 70% of patients taking Uloric 80 mg per day will achieve uric acid levels <6 mg/dl versus only 40% of patients taking allopurinol 300 mg per day. While there have been no known deaths reported due to gout attacks, this disease is very painful if an attack occurs, but you may find comfort in knowing that it is not life-threatening.