In most cases, gout is associated with a condition known as hyperuricemia. Hyperuricemia occurs when the blood contains raised levels of uric acid sustained over long periods. The kidneys process uric acid and excrete this through urine. When uric acid levels become raised, the kidneys are unable to eliminate uric acid efficiently. In some cases, the cause of gout is not linked to hyperuricemia but to kidney disease. Blood uric acid levels can arise when the kidney is not functioning properly. Whichever cause, the kidneys can become damaged when blood uric acid levels are raised over long periods.
The body unable to eliminate uric acid, deposits a hardened crystallised form of uric acid (tophi) usually in the joints and skin. Within the joints, deposits can be made in the joint fluid (synovial fluid) and joint lining (synovial lining).Common areas for these deposits are the ankles, feet and ball of the large toe. Less common areas of uric acid deposits include the ears and eyes. Tophi, areas of hardened uric acid, may also be seen under the skin around the fingers and toes.
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