Gout
Gout, complex disease of uncertain origin caused by the faulty metabolism of uric acid produced in the body by breakdown of protein, and resulting in elevated levels of uric acid in the blood. A diet rich in malt liquors, wines, and certain types of protein may precipitate individual attacks but does not cause the disease. Its incidence is not usually affected by climate or season; about 95 percent of sufferers are men. The disease is rare in people under the age of 30; from 10 to 20 percent of cases have a familial history. Acute attacks are characterized by severe pain in the joints, often in the big toe, but sometimes in the ankle, knee, hip, shoulder, wrist, or elbow. The attack usually begins abruptly; the joint becomes swollen, red, inflamed, and extremely tender. Untreated attacks last from a few days to a week or more. Repeated attacks may result in the development of a condition known as chronic tophaceous gout. In this condition crystals of uric acid lodge as white, chalky ma