What Is Gout in the Fingers?

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Gout is an inflammatory form of arthritis that occurs when uric acid crystals accumulate in the joints, causing painful and sometimes debilitating symptoms. While the most common area affected by gout is the big toe, it's possible to have gout attacks and flares throughout the body, including in the hands.

This article discusses gout in the fingers, including the most common symptoms, causes, treatments, and preventive measures.

Preventing Recurrent Gout Flares - Illustration by Ellen Lindner

Verywell / Ellen Lindner

Finger Gout Symptoms

The symptoms of gout are fairly consistent regardless of the location of the attack or flare-up. Common symptoms of finger gout include hands that are:

  • Swollen
  • Red
  • Hot
  • Suddenly and severely tender

In people with longstanding and poorly treated gout, tophi may develop in various joints of the hand.

Hand affected by gout

joloei / Getty Images

What Are Tophi?

Tophi are large, hardened accumulations of uric acid crystals within and around the joints. They can cause pain, deformities, and affect range of motion. Tophi can form anywhere, including in the fingers, tops of the ears, elbows, and even over the knees and shins.

In addition to affecting the fingers, gout can also affect the wrist, which would present as suddenly painful, red, hot, and swollen.

Causes and Risk Factors

Causes

Gout develops when an individual has an overabundance of uric acid, also known as hyperuricemia, within the body. An excess of uric acid can occur in the body due to:

  • Overproduction of uric acid
  • Under excretion of uric acid
  • A high-purine diet

Some people are genetically predisposed to form more uric acid in the body than others. This is typically because they lack necessary enzymes to metabolize purines (natural substances in food) into uric acid.

Other causes of excess uric acid production include certain types of cancers and blood disorders. Chemotherapy agents (medicines used to kill cancer cells) have also been found to influence purine production.

While some people naturally create more uric acid, others may not be able to properly eliminate uric acid through their kidneys. Chronic kidney disease and other disorders of the kidneys may lead to hyperuricemia.

While purines can be found within the body and metabolized into uric acid, certain foods contain higher purine content than others. Foods known to trigger a gout attack include:

  • Red meats
  • Shellfish
  • Liquor
  • Beer
  • Sugary beverages

One disease similar to and often confused with gout is pseudogout.

What Is Pseudogout?

While the symptoms of psuedogout are nearly identical to those of gout, pseudogout is caused by calcium crystals instead of uric acid crystals. Pseudogout causes red, painful, and swollen joints.

Risk Factors

Having one or more of the following risk factors puts an individual at a higher risk of developing gout:

Diagnosis

Diagnosing gout in the fingers can include obtaining a family history, performing a physical examination, and ordering lab and imaging tests.

While oftentimes the diagnosis may be clinical, healthcare providers may order additional testing to verify their suspicions.

  • History and physical: A thorough history, including a relevant family history, a description of recently consumed food and drink, and duration and onset of symptoms may help your healthcare provider come to a gout diagnosis. While symptoms of red, hot, tender, and swollen joints of the fingers are typical of various forms of inflammatory arthritis, a thorough history and additional testing can confirm finger gout. The presence of tophi can also be caught in a physical exam.
  • Joint aspiration: The definitive way to diagnose gout is by obtaining a fluid sample from an affected joint. Analysis of the specimen under a microscope will reveal crystals that are characteristic of gout.
  • Lab tests: A blood test measuring uric acid levels is also helpful in making a proper diagnosis. While some people with gout may have low-to-normal serum uric acid levels, most will have an elevated level of above 6.8 milligrams per deciliter. Measuring creatinine levels, which indicates the function of the kidneys, may also be valuable in the diagnosis as well.
  • Radiographic studies: During the initial stages of the disease, X-ray imaging of the hands may appear normal. However, with chronic and poorly controlled disease, bony erosions, joint space narrowing, and cartilage loss may all be visible.

Treatment

If left untreated, gout can progress from the occasional swelling in one joint to a more disruptive and debilitating disease, causing frequent painful flare-ups. Fortunately, there are medications and modifications which can help reduce the severity of attacks as well as help prevent future attacks.

In an acute gout flare up, medications such as corticosteroids, nonsteroidal anti-inflammatories (NSAIDs), or Mitigare (colchicine) can all be used to decrease the pain and swelling of the joints of the hand.

Treatment During a Flare-Up

You never want to start a long-term gout treatment during an acute flare-up. Starting uric-acid lowering medications such as allopurinol, Uloric, or Krystexxa during an acute flare-up will worsen the attack and lead to more debilitating symptoms. For that reason, it's best to get the initial flare-up under control prior to initiating chronic therapy.

Prevention

Lifestyle and dietary changes can play a big role in preventing future gout attacks in the hands, regardless of if a person is on medication or not.

The following preventive measures can all help reduce the likelihood of developing recurrent gout flares:

  • Weight loss
  • Increasing hydration (drinking fluids)
  • Avoiding high-purine foods
  • Taking appropriate medications regularly
  • Regular exercise

Summary

Gout in the fingers can be a disabling condition causing swelling, severe pain, redness, and warmth of the knuckles and smaller finger joints. Through numerous methods, a healthcare provider can promptly diagnose and treat gout both immediately and for the future. Several lifestyle modifications, along with proper treatment, can further decrease the chance of recurrent gout attacks in the hands.

A Word From Verywell

Gout can be an uncomfortable and painful condition. If you suddenly develop swelling and pain of your hands, be sure to contact your healthcare provider for proper management and treatment. In addition to medications, dietary and lifestyle changes can be crucial to preventing further attacks in the future.

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2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Rheumatology. Gout.

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