A gout flare is an intensely painful and disabling inflammatory arthritis, usually involving a single joint but occasionally involving two or more joints. The goal of therapy in a gout flare is prompt and safe termination of pain and disability. Without therapy, the gout flare usually resolves completely within a few days to several weeks, particularly in early disease. However, symptoms improve more quickly with administration of any of a broad array of antiinflammatory drugs
Upon resolution of a gout flare, the patient is said to have entered a symptom-free (interval, intercritical, or between flares) period. However, flares recur in the great majority of patients; with more frequent episodes, flares may be more severe and prolonged, with consequent shortening of asymptomatic periods. Patients with recurrent flares and those who develop chronic arthritis or tophi can benefit from long-term prophylactic therapy with a urate-lowering agent to prevent further recurrences of gout flare and chronic tophaceous disease.
The management of gout flares will be reviewed here. The approach to asymptomatic hyperuricemia; the pathophysiology, clinical manifestations, and diagnosis of gout; and the prevention of recurrent gout after resolution of the gout flares are discussed separately.