Draft — not published
Gout comes with a vocabulary that is rarely explained at the appointment where you first hear it. These are the terms that make the rest of the conversation easier to follow.
This page explains language, not what treatment is right for you. Medicine names describe what the medicines do; they are not instructions to start, stop or change one.
A prescription medicine that reduces how much urate the body makes. It is a form of urate-lowering therapy: its long-term job is to lower the urate so that new crystal formation can stop and existing deposits can dissolve once the level is held low enough. It is not a painkiller for a flare that is already happening.
A medicine that reduces inflammation—the heat, swelling and pain produced by the immune response during a gout flare. Colchicine, NSAIDs and corticosteroids can all be used for this purpose. They do a different job from medicines that lower urate over the long term.
A persistently high blood urate level without a previous gout flare or tophi. Asymptomatic means “without symptoms.” A high result alone is not the same as a gout diagnosis, and many people with high urate never develop gout.
A long-term reduction in kidney function. It matters in gout because the kidneys remove much of the body’s urate, and because kidney function affects which medicines and doses may be appropriate.
An anti-inflammatory medicine used for gout flares and sometimes in a low preventive dose when urate-lowering treatment begins. It calms the reaction to crystals; it does not lower the urate level itself.
A strong anti-inflammatory medicine, sometimes shortened to steroid. For a gout flare it may be taken by mouth or injected into a muscle or the affected joint, depending on the clinical situation.
A description of crystals breaking away from an existing deposit and becoming loose in the joint. The immune system reacts to those loose crystals, which can produce a flare. It helps explain why flares can temporarily increase when urate-lowering treatment starts.
A medicine that helps the body remove salt and water through urine, often prescribed for high blood pressure or heart conditions. Some diuretics can raise urate. Do not stop one on that basis; it is a reason to review the full medication list with a clinician.
A urate-lowering medicine that reduces urate production. Like allopurinol, it is a xanthine oxidase inhibitor. It is for long-term urate control, not immediate flare pain.
A sudden episode of intense joint inflammation caused by the immune system reacting to urate crystals. Gout attack means the same thing. A flare often brings severe pain, swelling, warmth and redness.
A higher-than-normal amount of urate in the blood. The US spelling is hyperuricemia. It creates the conditions in which urate crystals can form, but not everyone with hyperuricaemia develops gout.
Taking a small sample of synovial fluid from a swollen joint with a needle. The sample can be examined for urate crystals and, when needed, for signs of infection. You may also hear this called a joint fluid test.
Needle-shaped solid crystals that can form when urate no longer stays dissolved. The immune system’s reaction to these crystals produces a gout flare. Over time, deposits can collect in joints and in tophi.
Short for non-steroidal anti-inflammatory drug. Medicines such as ibuprofen and naproxen belong to this group and may be used for gout flares. They are not safe for everyone, particularly with some kidney, stomach, heart or bleeding problems.
Preventive treatment. In gout, it often means temporary anti-inflammatory cover given when urate-lowering therapy starts or changes, because the early treatment period can provoke flares. It is separate from the medicine lowering the urate.
Natural building blocks found in the body’s cells and in many foods. When purines are broken down, urate is produced. Food contributes to that process, but purines also come continuously from normal cell turnover inside the body.
A doctor who specialises in arthritis and other diseases of joints, bones and muscles. Many people have gout managed by a primary-care doctor; a rheumatologist may become involved when the diagnosis is uncertain, flares continue or gout is more complicated.
The concentration of urate measured in the blood. Serum refers to the liquid part of blood used for the laboratory test. SU is the abbreviation used in many gout guidelines and research papers.
Adjusting a medicine’s dose in planned steps, using follow-up results and clinical review. In gout articles it usually describes changing a urate-lowering dose until the agreed serum-urate target is reached. It does not mean adjusting the dose yourself.
A tophus is a firm deposit of urate crystals under the skin or around a joint; tophi is the plural. They can appear as lumps and, over time, can damage joints and nearby tissue.
A treatment strategy in which urate-lowering medicine is adjusted using repeated serum-urate tests until an agreed target is reached and maintained. It contrasts with leaving everyone on one fixed dose regardless of the blood result.
Long-term medicine used to lower the urate level. When that level is held low enough, new crystal formation stops and existing deposits can dissolve. Allopurinol, febuxostat and probenecid are examples. ULT treats the process causing gout; flare medicines treat inflammation and pain.
Blood urate may be reported in mg/dL, mmol/L or µmol/L. They are different scales for the same concentration, so a number only makes sense with its unit. Gout Journal can display all three.
Lab reports and everyday explanations often use these names interchangeably. This site usually says serum urate for the blood measurement and urate crystals for the deposits that cause gout, while using uric acid when that is the wording a patient is likely to see on a test result.
A type of urate-lowering medicine that helps the kidneys pass more urate into the urine. Probenecid is one example. This is a different mechanism from allopurinol and febuxostat, which reduce urate production.
A type of urate-lowering medicine that blocks an enzyme involved in producing urate. Allopurinol and febuxostat are the two names readers will encounter most often.
