Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board
Gout knee is an inflammatory condition characterised by intense pain and swelling of the knee joint.
Gout is a fairly common condition affecting approximately 1-2 people in every 100, affecting one million Americans each year.
Men are 2-3 times more likely to be affected than women and the peak age of incidence is 75. Gout is often extremely painful and recurrent episodes are common.
As well as affecting the knee, gout can also affect the big toe, hands, toes, ankles and wrists. It tends to only affect one joint at a time rather than being widespread.
If the knee suddenly becomes hot, painful, red and swollen, it is most likely due to Gout Knee.
Here, we will look at the common causes, knee gout symptoms and treatment, diagnosis & prevention of gout knee, and you can even find out about famous gout sufferers! You can also check out our Gout Knee FAQ's to see what questions other people are asking.
Gout knee pain is caused by high levels of uric acid, aka urate, in the blood.
Uric acid is a waste product of many food sources. It normally passes out in our urine, but with gout knee there is a problem with how the body metabolizes, or breaks down, the uric acid.
This can either lead to:
If the level of uric acid is too high, crystals can form in your soft tissues, usually around one joint such as the knee, resulting in gout.
The crystals cause an inflammatory response in the tissues leading to hot, swollen, red and painful joints.
The crystals tend to form at cool temperatures, which is why gout is so common in the hands and feet.
Uric acid levels are often raised for a number of years before gout knee symptoms develop.
Some people are more susceptible to gout than others and there is often little correlation between the levels of uric acid in the blood and knee gout symptoms.
In fact, approximately 50% of people with gout do NOT have hyperuricemia, high uric acid levels.
There are a number of other factors that increase your risk of developing gout knee pain:
Gout knee can develop any time after puberty, although in women, it tends to be after the menopause. This is thought to be due to the positive effect of oestrogen until then.
The symptoms of gout knee will vary from person to person and may fluctuate.
In most cases, the symptoms of gout in knee develop rapidly over a few hours, usually at night or in the early morning.
Common gout knee symptoms include:
Your doctor can normally diagnose gout knee by from what you tell him about your symptoms and your history such as any risk factors or previous episodes.
He can confirm the diagnosis of gout by doing blood tests, although these can be unreliable, or by removing a small amount of fluid from the knee joint, known as aspiration.
The fluid is examined under a microscope, looking for the presence of excessive uric acid crystals. Kidney function tests may also be done to confirm the diagnosis of gout knee.
Gout knee is a common cause of swelling in front of the knee but there are some other conditions that can too - check out the front knee swelling section.
Left untreated, gout knee episodes usually settle in a couple of weeks but they can last longer. There are a number of things you can do to help speed up the healing process and prevent further attacks of gout.
Gout knee treatment usually involves:
A common question with gout in knee is how long does it last? Most cases of gout knee are acute, sudden and short-lived. Left untreated, most episodes of gout knee settle down after a couple of weeks.
Unfortunately, repeat episodes are common and most people will suffer a recurrence of gout knee pain anywhere from 6 months to 2 years later. 60% of gout sufferers will have a recurrence within 1 year.
During the remission periods, people with gout knee may have no symptoms or experience only minimal discomfort. However, gout is a chronic condition and, without proper management, the frequency and intensity of gout attacks can increase over time.
Sometimes, gout spreads from the knee and affects more than one joint at a time, such as the big toe or hands.
There is also a risk of the uric acid causing crystals to form in the kidneys which can lead to inflammation, scarring and kidney stones.
There are a number of things you can do to help with gout prevention. The incidence of gout has doubled over the last 20 years. This is thought to be due to the increase in life expectancy, dietary changes and an increase in gout-associated diseases.
The best ways to reduce your risk of gout knee are to:
Fascinating fact time! I thought you might like to find out about some fellow gout sufferers:
People typically have a lot of questions about Gout Knee and how best to manage and prevent flare-ups.
We've compiled a list of commonly asked questions and answers, such as "What foods get rid of gout?" and "What happens if gout goes untreated?" - check out our article Gout Knee: Your Questions Answers
There are other conditions that cause knee pain at night, but whilst gout knee pain is not particularly common, it should always be considered with any sudden incidence of knee pain associated with swelling and redness.
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Page Last Updated: 23/05/23
Next Review Due: 23/05/25
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1. Gout: An Old Disease In New Perspective - G. Ragab, M. Elshahaly & T. Bardinc. Journal of Advanced Research, May 2017
2. Gout As Second Arthritis - S. Abedin. Arthritis Foundation
3. Gout & Pseudogout - B. Rothschild. Medscape, Jan 2019
4. Synovial fluid uric acid level aids diagnosis of gout - B. Vaidya, M. Bhochhibhoya and S. Nakarmi. Biomedical Reports, July 2018
5. Gout. NHS UK, August 2017