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In gout, monosodium urate crystals are deposited in and around the joint. They are also present in the synovial fluid, and they may cause acute inflammation.

A tophus may be formed in bursae, tendons, cartilage or periarticular bone.

Degenerative arthritis may result from damage to joint surfaces.

There may be urate crystal deposition in the kidneys and the formation of urate calculi in the urine. Crystal deposition in the renal parenchyma may result in renal failure - further exacerbating the condition.

The only way to truly distinguish gout from pseudogout is to look at the crystals under polarised light. Uric acid crystals in gout are negatively birefringent.

There is evidence that the immune system may accelerate the deposition of urate crystals. Antibodies against urate crystals may be responsible for the catalysis of crystal formation.

Last reviewed 06/2022