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As one of the nation’s top-ranked centers for rheumatology, Duke provides expertise in the diagnosis and treatment of gout. Our experts work closely with specialists throughout Duke to relieve your symptoms and help prevent future attacks. We want to help you resume a healthy, active life.

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About Gout

Gout is one of the most painful forms of arthritis. The sudden, intense, painful joint swelling and stiffness occur when uric acid builds up in the body, and sharp uric acid crystals deposit in the joints -- most often the big toe. Gout can also attack other joints, including ankles, heels, knees, wrists, fingers, and elbows.

If you need relief from the painful effects of gout, our doctors can help. We do comprehensive evaluations to assess the extent of your condition. We also work closely with you to determine the effectiveness of treatments and manage the possible side effects. We are leaders in researching therapies for gout and were involved in the development and testing of Krystexxa, a significant advance in the treatment of chronic, severe gout.

Our goal is to relieve the pain associated with acute attacks, prevent future gout attacks, and minimize your risk for long-term complications.

Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.


There is no cure for gout, but careful management of the condition may help keep it under control. Treatment options include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs reduce inflammation and help relieve joint pain.


Corticosteroids may be injected into the joint to relieve pain from a gout attack.


This pain reliever works best when taken within the first 12 hours of a gout attack.

Krystexxa (Pegloticase)

Given intravenously, this drug is used for chronic and severe cases of gout. It lowers uric acid levels and reduces deposits of uric acid crystals in joints and soft tissue. Krystexxa was developed and tested at Duke.

Lifestyle Modifications

We work with you to adopt diet and exercise habits that minimize your risk for a gout attack. This includes avoiding alcohol and sugary drinks, eating less meat, and drinking more water. Since gout often is associated with obesity, we also help you determine the best steps to manage your weight.

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Physical Exam

In addition to a physical examination of the affected area, your doctor will talk to you about your symptoms, medical history, and family medical history.

Blood Tests

Your doctor will order blood tests to measure the levels of uric acid in your system.

Joint Fluid Tests

Using a needle, your doctor takes a sample of synovial fluid from your affected joint to check for crystals associated with gout.

Imaging Tests

X-rays can reveal the extent of joint damage.

Leaders in Gout Care and Research

Access to Clinical Trials
Our rheumatologists are dedicated to identifying the best treatments for gout. As our patient, you may have the opportunity to participate in clinical trials to test the effectiveness of new drugs for treating this condition.

Team Approach to Care
Treating gout can be a challenge if you have other chronic conditions and regular medications. We work closely with your primary care physician, and with other specialists who care for you regularly, to ensure that your condition is being managed safely and effectively.

Best Hospital for Rheumatology in NC
Where you receive your care matters. Duke University Hospital’s rheumatology program is ranked among the very best in the U.S., and best in North Carolina by U.S. News & World Report for 2019–2020.