Gout in Knee: Causes, Symptoms & Treatments

Gout often affects the big toe joint, but it can also affect the knee. It’s one of many types of arthritis that can make your joints uncomfortable. Gout is an inflammatory arthritis that causes sudden and severe swelling, pain, and stiffness in a joint.

About 2% of people in the United States have gout. This article will explain the symptoms of gout in the knee, what causes it, how doctors diagnose it, the treatments available, ways to prevent it, and when to see a doctor.

What is Gout?

Gout is a painful form of arthritis that often affects the big toe but can also attack other joints, including the knees. It happens when your body has too much uric acid, which forms sharp crystals causing sudden pain, swelling, and tenderness.

When gout affects the knee, it can make walking or standing very painful. Although there is no cure, there are many treatments to prevent flare-ups and ease the pain.

Gout Symptoms in the Knee

Gout symptoms come on suddenly, often at night, and can be very uncomfortable. Here’s what to look for:

  1. Intense Joint Pain: Gout can affect various joints, not just the big toe. It commonly strikes the knees, ankles, elbows, wrists, and fingers. The worst pain occurs within the first 4 to 12 hours.

  2. Lingering Discomfort: After the initial intense pain, you might have ongoing discomfort that can last for a few days to a few weeks. Subsequent gout attacks may be longer and affect more joints.

  3. Inflammation and Redness: The affected joint(s) will swell, feel tender, become warm, and look red.

  4. Limited Movement: As gout progresses, you may find it harder to move the affected joint(s).

The Causes of Gout in the Knee

Gout in the knee happens because there’s too much uric acid in the blood. Our body naturally produces most of this uric acid, and some comes from breaking down certain foods high in proteins called purines.

Our kidneys usually help control uric acid levels by getting rid of the extra in our blood. In normal amounts, uric acid is a helpful antioxidant. But if there’s too much of it in the blood, called hyperuricemia, it can happen if the kidneys can’t remove it properly or if the body makes too much.

When hyperuricemia occurs, the extra uric acid can turn into tiny crystals in soft tissues or joints. These crystals tend to gather in or around joints because they are cooler places. When our immune system sees these uric acid crystals as foreign, it starts an inflammatory response that looks like the signs of an infection.

It’s essential to know that not everyone with high uric acid levels gets gout. In fact, about two-thirds of people with hyperuricemia don’t have this condition.

Who gets knee gout?

Gout is a painful problem caused by uric acid crystals in the body. About 4 percent of adults in the United States have it. It’s more common in men because women usually have lower uric acid levels. But after menopause, women’s uric acid levels go up, so older women are more likely to get gout.

We’re not entirely sure why some people have more uric acid or why it affects them differently, but genes seem to play a part. There are also things that can increase your chances of getting gout:

  1. Eating a lot of high-purine foods.
  2. Consuming foods and drinks, especially alcohol, that make your body produce more uric acid.
  3. Being overweight.

If you have high blood pressure or heart problems, you’re at a higher risk for gout. Taking diuretics (water pills) for these conditions can also make it more likely. Diuretics can raise uric acid levels in your body.

Factors That Can Increase Your Risk of Gout Knee Pain

Gout can affect people differently, and having high uric acid levels in your blood isn’t always a direct cause of knee pain from gout. Surprisingly, about half of people with gout don’t have high uric acid levels, a condition called hyperuricemia.

Here are some other things that can raise your risk of experiencing gout-related knee pain:

  1. Genetics: About 20% of gout cases seem to run in families, suggesting a genetic connection.

  2. Age: Gout is more common in people aged 40 and older, with the highest risk at around 75 years old.

  3. Obesity: Gaining weight rapidly or having a BMI over 35 can triple your chances of getting gout.

  4. Diet: Your food choices contribute to roughly 12% of gout cases. Risky factors include drinking too much alcohol (especially binge drinking), consuming fructose-based drinks, and having a diet high in seafood.

  5. Medical Conditions: Kidney problems and metabolic issues can make you more likely to get gout.

  6. Medications: Some drugs, like diuretics used for high blood pressure, heart problems, or swelling, can increase your gout risk.

  7. Injury: Gout in the knee might develop after an injury or surgery.

Keep in mind that gout in the knee can happen after puberty, but in women, it’s more common after menopause. This could be due to the protective effects of estrogen before menopause.

How to Get Diagnosed with Gout in Your Knee

If you think you might have gout in your knee, you should see a rheumatologist, a specialist in arthritis. Here’s what to expect during the diagnosis process:

  1. Physical Examination: The rheumatologist will examine your knee and ask about your symptoms, diet, lifestyle, and medical history.

  2. Diagnostic Tests: To confirm gout or another condition, your doctor may do the following tests:

    • Blood Tests: Check uric acid levels during flare-ups and in between.
    • Synovial Fluid Analysis: Examine fluid from your joint for white blood cells, signs of infection, and uric acid crystals.
    • X-rays: Rule out other joint problems and check for joint damage.
    • Ultrasound Scans: Detect uric acid crystals.

Diagnosing gout in your knee combines a physical exam and these tests to determine the best treatment plan.

How to Treat Gout in the Knee

Gout in the knee is very painful, and sadly, there’s no cure. But you can ease the pain and reduce how often it happens with a mix of medicines and home remedies.

Medicines

There are different medicines to help with knee gout pain:

  1. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs): Like ibuprofen (Advil).
  2. Prescription NSAIDs: Stronger ones, such as celecoxib (Celebrex) or indomethacin (Indocin).
  3. Corticosteroids: These can be taken as pills or injected into your knee to lower pain and swelling.
  4. Colchicine (Colcrys): This is for gout pain, but it might make you feel sick.

Your doctor might also suggest a low daily dose of colchicine to stop future flare-ups. There are other drugs to prevent gout flare-ups too:

  1. Allopurinol (Zyloprim) and febuxostat (Uloric): These reduce your body’s uric acid production and may stop gout from hurting other joints.
  2. Uricosurics: Drugs like lesinurad (Zurampic) and probenecid (Probalan) help your body get rid of extra uric acid. But they could make kidney stones more likely.

Home Remedies

To manage gout, you can make some changes in your diet and daily life. One of the best ways is to eat less food and drinks with a lot of purines because they turn into uric acid. Here’s what you can do:

  1. Cut down on red meat.
  2. Don’t have too much organ meat, like liver.
  3. Limit seafood, especially tuna, scallops, sardines, and trout.
  4. Drink less alcohol.
  5. Stay away from sugary drinks.

Instead of eating purine-rich stuff, try to have more fruits, veggies, whole grains, and lean proteins. This can help you lose weight, and that’s good because being overweight makes gout more likely.

Some home treatments might help with gout, but we don’t know for sure how well they work. You can give them a try if you want to see if they help with your knee gout.

Possible Complications of Gout

Gout can lead to more serious problems, such as:

  1. Recurrent Gout: Some people may have gout attacks multiple times a year if not treated. Medications can help prevent these attacks and avoid joint damage.

  2. Advanced Gout: If gout is left untreated, urate crystals can form lumps under the skin called tophi. These tophi can develop in various body parts like fingers, hands, feet, elbows, or Achilles tendons. Tophi may not be painful, but they can become swollen and tender during gout flare-ups.

  3. Kidney Stones: Gout can lead to the buildup of urate crystals in the urinary tract, causing kidney stones. Medications can be prescribed to lower the risk of developing kidney stones.

How Long Does Gout in the Knee Last?

People often wonder how long gout in the knee lasts. Typically, gout knee attacks are sudden and don’t stick around for long. If you don’t treat it, most gout knee problems go away within a couple of weeks.

But here’s the catch: gout in the knee can come back. Many people have more knee pain from gout anywhere from 6 months to 2 years later. In fact, about 60% of folks with gout will have another attack within just one year.

When gout is not acting up, you might feel fine or just have a little discomfort. But remember, gout is an ongoing thing. If you don’t take care of it, the attacks can happen more often and get worse over time.

When should you contact a doctor for gout?

If you think you might have gout and are experiencing symptoms, it’s vital to see a doctor for advice.

Gout can get worse with time, but getting treatment early can be very helpful in controlling it and lowering the chances of severe problems like joint damage.

Also, people with gout are more likely to get infections, especially if they have diabetes. So, if you see signs of an infection along with your gout symptoms, it’s important to get immediate medical help.

FAQs

1. Can gout happen after a knee replacement surgery?

Yes, it’s possible but uncommon. Detecting gout in a replaced knee can be tricky as it might look like a knee infection. Diagnosing it involves finding uric acid crystals in the knee fluid or a history of gout attacks.

2. Is gout possible in the hip?

Yes, but it’s very rare. Gout in the hip may be mistaken for another condition. It doesn’t show typical signs like swelling or redness. An ultrasound can reveal gout, and analyzing hip fluid for uric acid crystals can help diagnose it.

3. Are there any connections between gout and other health conditions?

Recent studies suggest a link between gout and a higher risk of anxiety, depression, and heart attacks.

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