Dr. Abhijeet Bhosikar

Gout & High Uric Acid Treatment in Pune & PCMC

The most curable arthritis there is — and the most commonly mistreated.

Book a consultationCall +91 70571 19999

Ravet, Pimpri-Chinchwad · OPD Mon, Wed, Fri

Close-up of tablets in a blister packIllustrative

Overview

What this group of conditions has in common

Crystal arthritis happens when crystals form inside a joint and trigger sudden, ferocious inflammation. In gout the crystal is monosodium urate; in pseudogout it is calcium pyrophosphate. The attacks look almost identical and the treatments are completely different.

Gout is genuinely curable in the sense that matters: hold serum urate below 6 mg/dL continuously and the crystals dissolve, attacks stop permanently and tophi disappear. Almost every treatment failure comes from treating only the attacks and never lowering the urate.

The other half of the job is undoing misinformation. Dal, tomatoes and spinach are not meaningful gout triggers. Beer, spirits, sugary drinks, red meat, organ meat, weight and certain blood pressure tablets are.

A glass of water on a pale surfaceIllustrative
Two to three litres of fluid a day helps the kidneys clear urate, unless fluids have been restricted for another reason.

Recognising it

The clues that point to this group

Pattern recognition does more diagnostic work in rheumatology than any single test. These are the features that matter here.

  • Sudden and severe

    Pain that goes from nothing to unbearable within hours, often waking the patient in the early morning. A bedsheet on the joint is intolerable.

  • It settles on its own

    An untreated attack resolves over 7–14 days and the joint looks normal again. That false reassurance is exactly why the underlying urate is never addressed.

  • The joint pattern differs

    Gout classically starts at the base of the big toe. Pseudogout favours the knee and wrist and becomes common with age.

  • It signals cardiometabolic risk

    Gout travels with obesity, hypertension, kidney disease and diabetes. Finding it is a reason to check all of them.

Investigation

The tests that separate these conditions

Only the investigations that answer a specific question — plus the safety screening required before any immunosuppression.

  • Joint aspiration with polarised microscopy

    The gold standard — identifies the crystal definitively and simultaneously excludes infection.

  • Serum uric acid, timed correctly

    Can be normal or low during an acute attack. Must be rechecked at least two weeks afterwards or gout gets wrongly excluded.

  • Ultrasound double-contour sign

    A bright band of urate coating the cartilage — non-invasive, highly specific, and useful for tracking crystal clearance.

  • Kidney function and metabolic panel

    Creatinine, lipids, HbA1c and blood pressure, plus a review of any diuretic that may be driving the urate up.

Treatment

How this is treated, step by step

A defined sequence with a defined review point at each stage — not an open-ended prescription.

  1. 01

    Treat the attack fast

    Low-dose colchicine, an NSAID or a short steroid course started within the first 24 hours. Speed matters more than the choice of drug.

  2. 02

    Confirm the crystal

    Aspiration where feasible. Urate-lowering drugs do nothing for pseudogout, so the distinction is not academic.

  3. 03

    Lower urate to a target

    Allopurinol started low and titrated up, or febuxostat, aiming below 6 mg/dL — or below 5 if tophi are present. Titrated to the number, not left at the starting dose.

  4. 04

    Cover the first months

    Low-dose colchicine for three to six months during initiation. Skipping this causes early flares, which is why patients wrongly conclude the drug does not suit them.

  5. 05

    Fix what is driving it

    Weight, alcohol, sugary drinks, hydration, and switching a thiazide to losartan or a calcium channel blocker where blood pressure allows.

Conditions in this group

2 conditions treated under gout & crystal arthritis

Each has a full patient guide covering symptoms, diagnosis, treatment and the warning signs that need urgent attention.

  • Crystal & Metabolic

    Gout

    The most curable form of arthritis — and the most commonly mistreated.

    Read the guide
  • Crystal & Metabolic

    Pseudogout (CPPD)

    Gout's mimic — same fury, different crystal, different treatment.

    Read the guide

Do not wait for an appointment if you have

  • A hot swollen joint with fever — septic arthritis can look identical and is an emergency
  • Any rash after starting allopurinol — stop the drug and seek review immediately
  • Loin pain or blood in urine suggesting urate stones
  • Ulcerating or discharging tophi

Call the clinic on +91 70571 19999 or attend the nearest emergency department.

Questions

FAQs — gout & crystal arthritis

My uric acid is high but I have no pain. Do I need tablets?
Usually not. Asymptomatic hyperuricaemia rarely requires urate-lowering drugs. It does require attention to kidney function, blood pressure, weight, alcohol and any medication causing it. Treatment normally starts after a proven attack, a tophus, urate stones or significant kidney disease.
Should I stop eating dal and tomatoes?
No. This is the most common piece of misinformation in Indian gout care. Vegetable purines have little effect on gout risk and tomatoes are not a meaningful trigger. Beer, spirits, sugary drinks, organ meat, red meat, shellfish and overall weight are what actually matter.
My gout got worse after starting allopurinol. Should I stop?
No — continuing is the answer. Lowering urate mobilises existing crystals, which can provoke flares in the first few months. This is expected and temporary, and it is precisely why low-dose colchicine cover is prescribed alongside.

Also treated

Other treatment areas

Get a specialist opinion on gout & crystal arthritis

Consultations at the Ravet clinic in Pimpri-Chinchwad. Bring your previous reports — a properly reviewed history usually saves repeating tests.

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