What Is Gout of the Bones?

Gout is a fairly common problem for people who are overweight or have kidney disease, and the build-up of uric acid crystals in the joints can be painful. But severe cases can lead to a condition known as gout of the bones in which deposits build up and remain on bones.

What is Gout of the Bones

• Gout of the bones, also known as gouty arthritis, occurs when deposits or uric acid crystals called tophi build up in the joints and adjoining bones. The tophi deposits create harden knots that can lead to joint erosion and damage and produce severe pain.

How Tophi Accumulates

• According to a study in the Annals of Rheumatoid Disease (ARD), tophi deposits began as soft, pliable lumps that become harder with each gout flare-up as uric acid crystals accumulate and harden in the joints. Over time, the soft lump calcifies and hardens into a solid knot.

Where Deposits Form

• Tophi deposits usually form on the joints of the fingers, the big toe and at the tip of the elbow. The knots can be quite large, sometimes as large as golf ball, and produce extreme pain. In rare cases, nodules can form on the spine and cause major damage.

Bone Erosion

• The ARD study also concludes that uric acid deposits and resulting tophi deposits are "a dominant mechanism for development of bone erosion and joint damage in gout," particularly as the nodules grow larger and create more pressure on the joints and surrounding cartilage.

Secondary Problems

• People with gouty arthritis are prone to kidney problems. About 40 percent develop problems like kidney stones and 25 percent eventually develop progressive kidney disease that may lead to kidney failure.

Treatment

• Once tophi nodules form and harden, they cannot be eliminated. The best course of treatment is to determine the underlying cause of the gout, which include obesity, impaired kidney function and heavy alcohol consumption, and try to eliminate it to prevent gout attacks and the resulting build-up of tophi.