What causes gout and gouty arthritis?

Gout and gouty arthritis are primarily caused by the abnormal metabolism of purine nucleotides, leading to an overproduction or decreased excretion of uric acid. Purines are naturally occurring substances found in various foods and are also produced by the body. When purine metabolism is disrupted, it results in elevated levels of uric acid in the blood, a condition known as hyperuricemia.

When uric acid levels become excessively high, monosodium urate crystals can form and deposit into joints and surrounding tissues, triggering an inflammatory response. This can lead to the painful and swollen joints characteristic of gout attacks.

While excessive joint movement, steroid use, and infectious agents can affect joint health and may lead to other types of arthritis, they do not directly cause gout or the specific metabolic disturbances associated with high uric acid levels. Therefore, abnormal metabolism of purine nucleotides is the underlying factor leading to the development of this condition.