Arthritis caused by deposition of monosodium urate crystals.
Key points
• Sudden, severe pain and swelling, classically of the big toe (podagra).
• Caused by hyperuricaemia; triggers include alcohol and purine-rich food.
• Acute flare: an NSAID, colchicine or a corticosteroid as appropriate; long-term urate-lowering therapy such as allopurinol is usually started after the flare settles, though it may be started during a flare in selected patients, particularly when flares are frequent.