What Are Gout and Pseudogout?

Written by Evan Starkman
Medically Reviewed by Zilpah Sheikh, MD on November 12, 2025
7 min read

Gout can strike suddenly, often without warning — and for some reason, in the middle of the night. It’s an intense pain in a joint, most often the big toe, but it can sometimes affect other joints, including knees, ankles, elbows, thumbs, or fingers.

Attacks of gout can be unexpected and intensely painful. With prompt treatment, the pain and inflammation usually disappear after a few days. But they may happen again at any time.

About 9-12 million Americans have gout. Gout happens more often in men than in women. Men usually develop it between the ages of 30 and 50. Women are more prone to gout after menopause. It is rare in children and young adults. Men who are overweight or have high blood pressure are particularly prone to gout, especially if they are taking thiazide diuretics (water pills).

Gout is actually a form of arthritis. It is the body's reaction to irritating crystal deposits in the joints. The pain can be intense, but treatment usually works very well. Mild cases may be managed by diet alone. Gout attacks that keep coming back may require long-term medication to ward off damage to the bone, cartilage, and kidneys.

People with chronic gout may feel tiny, hard lumps building up over time in the soft flesh of areas such as the hands, elbows, feet, or earlobes. These deposits are called tophi. They’re concentrations of uric acid crystals and can cause pain and stiffness over time. If similar deposits form in the kidneys, they can lead to painful and potentially dangerous kidney stones.

Too much uric acid in the blood causes gout. Uric acid comes from two sources: Your body makes it, and it also comes from your diet. Any extra uric acid usually filters through the kidneys and gets passed in urine. If the body makes too much uric acid or doesn't get rid of it in urine, crystals of monosodium urate form in the joints and tendons. These crystals cause intense inflammation, leading to pain, swelling, and redness.

Risk factors for gout

Some things that can raise your risk of gout are:

Eating and drinking habits. Gout used to be known as "the disease of kings," as it was mainly seen in wealthy men who drank and ate too much. Now we know it can happen to anyone.

The most common risk factor is drinking too much alcohol, especially beer.

Diets that are high in these foods are also tied to gout:

  • Red meat, such as bacon, beef, and pork
  • Turkey, especially the processed kind sold in delis
  • Organ meats, such as tripe, liver, sweetbreads, and kidneys
  • Game meats, such as veal, goose, and venison
  • Meat sauce and gravy
  • Seafood, such as tuna, trout, haddock, scallops, mussels, herring, and codfish
  • Sugary drinks and snacks
  • Packaged or processed foods that have lots of high fructose corn syrup in them

Certain conditions. Some health issues linked to gout are:

  • Certain tumors or cancers
  • Kidney disorders
  • Enzyme deficiencies
  • Lead poisoning
  • Psoriasis
  • High blood pressure
  • Diabetes
  • Congestive heart failure
  • Obesity and overweight
  • Injuries
  • Stress

Also, repeat attacks of gout are common if you're having trouble keeping your body's uric acid level under control.

Certain treatments. Some medicines linked to gout are:

  • Antibiotics
  • Low-dose aspirin
  • Blood pressure drugs, such as thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and beta-blockers
  • Medicine to prevent rejection of transplanted organs

A recent surgery or hospital stay could trigger a gout attack. And some people get a flare-up after they get a vaccination.

Family history. Gout may be passed down in your family.

If gout runs in your family, men should especially limit alcohol, fats, and foods that are more likely to raise the uric acid level in the body. Those include meat, sardines, bacon, mussels, and yeast. Beer, especially, can also bring on a gout attack. Drinking plenty of liquids may help lower the risk of kidney stones. Your doctor can do blood and urine tests to figure out your potential risk of a gout attack. Men who are at greater risk of gout should also watch their weight.

If you often have gout attacks, medications can help prevent them. These drugs either lower the production of uric acid or increase its removal through urine. These medicines include:

If these medications aren't effective, your doctor may prescribe febuxostat (Uloric). If you have heart issues, be very cautious when taking febuxostat.

Pseudogout is similar to gout but generally less painful. It is caused by calcium pyrophosphate (CPP) crystals in the joints. The crystals can build up in the joint fluid, which can cause a sudden attack of pain, similar to gout.

It's not clear what causes the abnormal deposits of CPP crystals in cartilage. They may form due to unusual cells in the cartilage or result from another disease that damages cartilage. CPP crystals may be released from cartilage during a sudden illness, joint injury, or surgery. The abnormal formation of CPP crystals may also run in the family.

While pseudogout can affect the big toe, it is more common in larger joints such as the knee, wrist, or ankle. Less often, it can involve the hips, shoulders, elbows, finger joints, or toes.

Pseudogout is more common after age 60.

The type of pseudogout treatment depends on several factors, including your age, other medications you're taking, your overall health, your medical history, and how severe the attacks are. Drugs to treat pseudogout include:

  • Anti-inflammatory painkiller drugs, also called nonsteroidal anti-inflammatory drugs (NSAIDs), are generally prescribed to treat sudden and severe pseudogout attacks. NSAIDs, such as ibuprofen and naproxen, usually lower inflammation and pain within hours.
  • Corticosteroids (also called steroids) may be prescribed if you can't take NSAIDs. Steroids also work by lowering inflammation. They can be injected into the affected joint or given as pills.
  • Colchicine, a gout drug, is sometimes used in low doses for a longer period to lower the risk of repeated attacks of pseudogout.

Anti-inflammatory medications are usually continued until the pseudogout attack goes away. Symptoms are often better within 24 hours after treatment begins.

When you get a gout attack, you may get some relief by trying these simple tips:

  • Stay away from intense exercise and physical activity to give your painful joint a rest.
  • Keep your affected joint raised above your heart level during rest.
  • Soothe your joint with an ice pack wrapped in a thin towel or with a cold compress for 15-20 minutes. You can do this several times a day.
  • Sip lots of water.
  • Skip alcohol and sugary drinks.
  • Try not to eat high-purine foods, such as red meat and certain seafoods. 

Over the long run, it's also a good idea to lose extra weight. Low-impact exercises, such as walking, swimming, and biking, are gentler on your joints and can help you lose weight.

Call your doctor if strong pain suddenly flares up in a joint. Fast treatment for gout can keep pain and joint damage from getting worse.

Get medical help right away if you get a fever and your affected joint seems hot and swollen. You might have an infection that needs treatment.

Tests to determine gout

You might need various tests to find out if gout is causing your symptoms. Some of these tests are:

  • Imaging tests. Your doctor may recommend an X-ray, ultrasound, MRI, or CT scan.
  • Blood test. This lets a lab check the level of uric acid in your blood.
  • Joint aspiration. Your doctor uses a needle to take a fluid sample from inside your joint. A lab checks the fluid for crystals of monosodium urate.

Gout is a type of arthritis that causes intense pain in a joint, most often the big toe. With quick treatment, the pain and inflammation usually go away after a few days. Get medical care right away if you run a fever and your affected joint seems hot and swollen. Pseudogout is similar to gout, but it tends to be less painful. Its symptoms often get better within 24 hours after you start treatment.

Does drinking lots of water help with gout?

Yes. Water helps your kidneys work well. Healthy kidneys do a better job of filtering uric acid from your blood, which helps prevent gout attacks.

What's the fastest way to flush out gout?

 Sip plenty of water and avoid sugary drinks and alcohol.

Is coffee bad for gout?

Some research actually links coffee to a lower risk of gout. But ask your doctor how much is OK for you to drink. They may tell you to avoid it if you have certain other health conditions.

What else can mimic gout symptoms?

Aside from pseudogout, another condition that can bring on symptoms similar to gout is rheumatoid arthritis (RA). RA can cause pain and swelling in several joints, which may seem like severe gout. But these two conditions have different causes and treatments.