Gout, or metabolic arthritis, is a condition created by a buildup of uric acid crystals on the cartilage of joints, tendons, and surrounding tissue, causing inflammation, severe pain, redness, stiffness, and even low-grade fever. If not treated, the crystals can form a tophi (Latin for “stone”), which can lead to tissue damage. Gout is caused by high concentrations of uric acid (hyperuricemia) combined with overall acidity in the bloodstream. Separately, high levels of uric acid or blood acidity alone normally do not cause gout. The condition most often occurs in men, but it can affect women as well. Gout most often attacks the big toe, comprising roughly 75  percent of first attacks, but it can attack other joints such as the ankle, heel, instep, knee, wrist, elbow, fingers, and spine. Patients with longstanding hyperuricemia may have uric acid crystal deposits in other areas such as the outer part of the ear. High levels of uric acid in the urine can lead to uric acid kidney stones. Treatment typically involves medication.

The UAB Division of Clinical Immunology and Rheumatology has consistently been ranked as one of the top 12 clinical rheumatology programs in the country by U.S. News & World Report. It is internationally recognized for its dedication to advancing knowledge and translating research findings into more effective diagnosis and treatment of patients with rheumatic diseases such as rheumatoid arthritis, gout, lupus (systemic lupus erythematosus, or SLE), osteoporosis, scleroderma, dermatomyositis, polymyositis, vasculitis (including Wegener’s granulomatosis), and related diseases. As one of the largest academic rheumatology programs in the nation, the division’s clinical practice logs more than 10,000 visits annually, evaluating and treating patients with various forms of connective tissue disease. It is staffed by practitioners and specialists in multiple fields, making it easier for physicians to collaborate toward more effective patient care.

Since the division’s formation in the 1950s, our rheumatologists have contributed substantially to the understanding of rheumatic diseases, including their pathogenesis, clinical manifestations, and current diagnostic and therapeutic approaches. They work closely with specialists in musculoskeletal radiology to provide the most advanced imaging techniques and interpretation of radiographs, CT scans, and MRI scans. The Interdisciplinary Infusion Center at The Kirklin Clinic of UAB Hospital provides ready access to the latest FDA-approved intravenous medications for many rheumatic diseases.

With support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, we launched the UAB Center of Research Translation on Gout and Hyperuricemia. The center includes the UAB Gout Clinic, located within the Rheumatology clinic at The Kirklin Clinic of UAB Hospital, where UAB experts come together in one location to deliver cutting-edge patient care and conduct advanced research on gout, which affects an estimated 4% of the U.S. population. This team combines expertise in rheumatology, nephrology, and cardiology to focus on better understanding how gout is influenced by genetics and environmental factors, with the goal of more accurate diagnoses and increasingly effective treatments.

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