Characteristics of a gout flare

Characteristics of a gout flare

Early gout flares are typically monoarticular (85%–90%), begin abruptly, and reach maximal intensity within hours. Flare onset often occurs during the night or early morning when the joint is most cool. The affected joint becomes exquisitely painful, warm, red, and swollen. A low-grade fever may be present. Periarticular erythema and swelling may progress to resemble an aseptic cellulitis that can be confused with an infectious process. Gout flares also occur in periarticular sites, such as the Achilles tendon or olecranon or prepatellar bursa. Early in the course of gout, flares are self-limited and resolve over 3 to 10 days with a return to “baseline”. Desquamation of the skin overlying the affected joint can occur with resolution of the inflammation. Subsequent attacks of gout can occur more frequently, become polyarticular, and persist longer.

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