Knee Gout: Symptoms, Causes, and How to Treat It

Medically Reviewed By Stella Bard, MD

Gout is a form of inflammatory arthritis. It occurs when uric acid crystals build up in joints, including the knee. Gout in the knee causes intense pain with swelling, stiffness, and redness. Gout is more common in males than in females, according to a 2020 research study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source that looked at the global epidemiology of gout. Another 2020 study Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source indicated that gout is more common in developed countries, but its incidence is now increasing in developing countries as well. 

Gout tends to occur in middle-aged adults. It rarely affects children or adolescents unless there is an underlying condition contributing to it.

This article provides details about knee gout, including symptoms, causes, treatment, and potential complications.

Sex and gender exist on spectrums. This article will use the terms “male” and “female” to refer to a person’s sex assigned at birth.

What is gout?

Gout is a painful type of inflammatory arthritis. It is caused by a buildup of uric acid levels that form crystals in a joint. It often affects one joint at a time. 

Gout typically affects the big toe joint, but it can also affect other joints. Depending on the joint affected, you will feel pain and reduced flexibility in that joint and in surrounding areas.

Gout can affect these areas Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source of the body:

  • any joint, including ankles, knees, smaller toes, and hands
  • bursae, which are fluid filled sacs around the joints
  • membranes that cover tendons
  • kidneys, which leads to kidney stones and possibly kidney damage

When gout occurs in the knee, it causes intense swelling, redness, and pain in the knee joint. It can make everyday movements, such as walking and climbing stairs, painful and difficult.

In severe cases, gout can cause more intense symptoms that recur more often. This can lead to the formation of nodules underneath the skin, called tophi. It can also lead to kidney stones. 

Treatments can help relieve its symptoms. There is no cure for gout, but there are ways to avoid gout flare-ups.

What are the symptoms of gout in the knee?

Person sitting and holding their knee
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Gout in the knee causes a burning sensation. The attack can come suddenly, making it feel like your knees are on fire. It is common for gout attacks to occur at night.

Some common symptoms of gout in the knee include:

  • Intense pain in your knees: Intense pain may start suddenly or gradually in your knee and then linger. The severe pain may last 4–12 hours before it lessens. 
  • Inflammation of the knee area: The knee may be swollen, look red and inflamed, and feel warm. 
  • Discomfort that lingers: Gout pain and symptoms last for a few weeks before they subside.
  • Limited flexibility: Gout in the knee may limit range of movement in the knee joint.

What causes gout in the knee?

Gout in the knee is caused by the buildup and accumulation of uric acid in the blood. High uric acid levels in the blood is called hyperuricemia. It can cause tiny sharp crystals, called urate crystals, to form in and around the knee joint. The crystals cause inflammation, including swelling, heat, redness, and the pain you feel. 

The body produces most of the uric acid naturally. However, diet plays a role in high uric acid levels that lead to gout. Protein-rich foods, such as beans and organ meat, contain a high amount of purines. When the body processes purines, uric acid forms.

The kidneys are responsible for filtering out uric acid from the blood and excreting it as urine. Health conditions, foods, and medications can increase uric acid levels or make it difficult to clear uric acid. These include:

  • chronic kidney disease
  • low dose aspirin, diuretics, and the B vitamin niacin
  • foods and beverages containing high levels of purines

Hyperuricemia is elevated uric acid levels in the blood. Having hyperuricemia increases the chances of uric acid leaving the bloodstream and forming urate crystals in joints. The immune system recognizes these crystals as foreign substances. It responds by causing the inflammatory reaction during a gout flare-up. 

What are the risk factors for developing gout?

Some factors may increase your risk of developing gout in the knee. According to the Arthritis Foundation, the factors include:

  • being older
  • being male
  • having a family history of gout
  • being overweight

Other factors that can trigger knee gout include:

  • experiencing a knee injury, including repetitive injuries
  • eating protein-rich foods
  • drinking alcohol

How do doctors diagnose gout in the knee? 

Gout has similar symptoms to other inflammatory diseases. Doctors diagnose gout Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source by:

  • examining the affected knee
  • discussing your medical history, including any existing conditions and treatments
  • discussing your symptoms in detail, including when they occur and the severity of your pain

Tests to rule out other conditions and confirm a gout diagnosis include:

  • imaging tests to examine the bones, bursae, and tendons around the joint
  • blood tests to measure uric acid levels
  • synovial fluid analysis to check for white blood cells and uric acid crystals

Your primary care doctor may refer you to a rheumatologist. This doctor specializes in treating inflammatory diseases and other types of arthritis.

What are treatments for gout in the knee?

Gout is a chronic disease. The goal of treatment is to manage the disease. This includes Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source :

  • alleviating pain during a gout flare
  • reducing the frequency and severity of flares
  • preventing damage to joints and organs by treating tophi found in later stage gout 

Treating an acute gout attack

Treatment for an acute gout attack or flare involves:

  • anti-inflammatory medication colchicine (Colcrys) as soon as symptoms begin
  • corticosteroids
  • nonsteroidal anti-inflammatory drugs
  • local ice therapy, such as cold compresses to reduce swelling and pain
  • rest

Other things you can do to help treat a gout attack in the knee include:

  • Protect your knees and avoid activities that can injure the joint.
  • Participate in knee friendly exercises, such as walking and swimming.
  • Drink plenty of water to help flush out excess uric acid.
  • Manage stress levels and get proper rest because stress can trigger a gout flare.
  • Maintain a moderate weight.
  • Avoid drinking alcohol.
  • Avoid foods that can trigger a gout attack, such as red meats, liver and kidney, sugary foods, and full fat dairy products. Also avoid some seafood, such as mussels, sardines, trout, tuna, and mackerel.
  • Avoid medications that can trigger a gout attack, such as niacin, cyclosporin, aspirin, and beta-blockers.

Talk with your doctor before stopping any medications or making major changes to your diet.

How long does gout last in the knee?

A gout attack may occur suddenly, particularly when the uric acid levels spike or the crystals in the joints shift. The pain can be intense for the first 12 hours, after which point it may start subsiding. Without treatment, gout symptoms can last for 10–14 days. 

Start treatment early to reduce the duration and severity of the flare-up. Even when the symptoms subside, continue applying precautionary measures to protect your knees. This includes avoiding foods that may trigger frequent flare-ups. 

What are the potential complications of knee gout?

Knee gout is usually not fatal. However, it can cause complications such as permanent joint damage and intense chronic pain

When knee gout recurs several times each year, it can cause constant pain and erosion of the knee joint. Untreated, gout can worsen to advanced gout. At this stage, urate crystals form in tophi, which are nodules underneath the skin. Tophi can become tender and swollen during gout flare-ups.

Summary

Gout is a common arthritis-related condition that can affect the knees. See your doctor for symptoms of gout, to receive a proper diagnosis, and for a treatment plan. Gout tends to worsen over time. Early treatment can shorten the duration of gout attacks, help prevent frequent attacks, and reduce the risk of severe complications. 

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Medical Reviewer: Stella Bard, MD
Last Review Date: 2022 May 31
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