Dr Samantha Hider

Brief Outline: Dr Samantha Hider explains who gets gout, and how it should be diagnosed and monitored. She also talks about some of the other health issues that are associated with gout, and what checks may be done to look for them.

Background: Dr Samantha Hider is an Honorary Consultant Rheumatologist in the Staffordshire and Stoke-on-Trent Partnership NHS Trust, and Senior Lecturer in Clinical Rheumatology at Keele University. Her research interests include the management of common rheumatology conditions such as gout and rheumatoid arthritis and the impact these conditions have on other long term health conditions, such as heart disease.

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Dr Samantha Hider is a part-time Honorary Consultant Rheumatologist in the Staffordshire and Stoke-on-Trent Partnership NHS Trust, and Senior Lecturer in Clinical Rheumatology at Keele University. Following her PhD and registrar training in Manchester, she moved to Keele University in 2007 and was appointed to her current post in 2009. Her research interests focus on the optimal diagnosis and comorbidity of common inflammatory rheumatological problems, including gout, polymyalgia rheumatica and rheumatoid arthritis. She is currently involved in several research studies looking at vascular disease (heart attacks and strokes) and gout, and studies looking at the effect of gout on quality of life. 

A consultant rheumatologist explains who can get gout and what the most common causes are.

Anyone can get gout - it's one of the commonest reasons for inflamed joints. About one in 100 people in the UK have gout. We know gout affects more men than women, and it's unusual in women before they have their menopause. People with gout often have other health conditions, like being overweight, or having kidney disease or diabetes. But people often think that gout is self-inflicted and caused by eating the wrong types of food or drinking too much alcohol, whereas in fact for most people, their gout is caused by a combination of their genetic makeup, or their other health conditions, or the tablets they take.

A consultant rheumatologist talks about the different tests that can be done to diagnose gout.

Gout is most usually diagnosed from a combination of clinical signs, so what the joint looks like, and the symptoms that a patient presents with. To diagnose gout with 100% certainty you can draw fluid from an affected joint and look for crystals - uric acid crystals in the fluid. But it's often difficult to do that, particularly in joints like the big toe, and GPs often don’t do that, so it's usually a clinical diagnosis. 

We can also do blood tests to measure the level of uric acid in the blood, but sometimes during acute attacks the blood tests can be normal, and so it doesn't help us. In people who have had gout for a long time, there may be changes on x-rays which are typical of gout, but again if you’ve only had a first attack of gout these may be normal. 

Once gout is diagnosed it's important to check for other conditions that are linked with gout, such as diabetes, high cholesterol, or kidney disease. In terms of keeping an eye on people once they're on treatment for gout, it's important to check uric acid regularly, as that gives a marker of how the treatment is working, and we aim as doctors to make the uric acid level quite low, so we monitor this. It's also important to check kidney tests and these are done usually through blood tests. We know that people who have gout are more likely to have other health conditions, such as heart disease, and so people with gout are often invited for extra health checks, to check things like blood pressure and to screen for things like diabetes.

A consultant rheumatologist explains why it is important to monitor uric acid levels.

Once gout is diagnosed it's important to check for other conditions that are linked with gout, such as diabetes, high cholesterol, or kidney disease. In terms of keeping an eye on people once they're on treatment for gout, it's important to check uric acid regularly, as that gives a marker of how the treatment is working, and we aim as doctors to make the uric acid level quite low, so we monitor this. It's also important to check kidney tests and these are done usually through blood tests. We know that people who have gout are more likely to have other health conditions, such as heart disease, and so people with gout are often invited for extra health checks, to check things like blood pressure and to screen for things like diabetes.

A consultant rheumatologist explains why it is important to monitor people with gout for other health issues.

People with gout often have other health issues, such as being overweight, or having diabetes, having high cholesterol, or having kidney disease, and so it's important to look for and treat those conditions in people with gout. 

People with gout are also more likely to have problems like heart attacks and strokes, and so because of that we monitor people with gout and keep an eye on blood pressure, cholesterol, blood sugar, so sometimes people with gout are asked to go for health checks in their GPs which they may not otherwise be asked to go for.