Keith’s GoutPal Story 2020 Forums Please Help My Gout! Question about lack of pain in gouty swollen knee

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    I was diagnosed a week ago with gout. Once again I am a 25 year old female. No known health problems. Last week my left knee swelled first. No pain just swelling (no redness either). The next day it hit my right knee. Same thing. Both knees were aspirated and came back positive for the crystals. But I was never in the pain anyone seems to reference. Not that I am complaining just wondering if this is normal!? TIA

    Richard Bell

    It may mean that your imune system hasn’t started attacking the crystals in your joints YET. I suggest you get your SUA level tested or if it has been tested find out from your doctor what the number is. Don’t settle for “it’s good” as a responce, get the number. If you are over 6.0 then ask your doctor about allopurinol as treatment to lower your SuA or if your in the USA you can also ask about Uloric as treatment. Pain or no pain, you will need to get your SUA number below 6.0 to start desolving crystals and get the swelling down. I am currently taking 80mg of Uloric and have lowerd my SUA to 4.4 at last testing.


    It certainly isn't normal in my case, but I can recall a few occasions in knees ankles and elbows when I scan my memory. I cannot recall exact circumstances, but I will keep an eye out for it in future and see if any pattern forms. I guess I've just thought myself lucky that there is no pain.

    Does anyone else know if there might be other risks involved here?

    There is certainly very little online information about “painless gout”, but what I did find is fairly fascinating (to me). Those of a nervous disposition should look away now, as a picture follows.

    The article “A painless, swollen finger (for 20 years)” comes from the LancetMarch 2008 :

    A 94-year-old woman was referred to a dermatology clinic with a painless, smooth, hard swelling over the proximal interphalangeal joint of her left little finger (figure). The swelling had been present for 20 years. We could see yellow-white material under the skin. The patient had similar changes over the metatarsal joints of her feet, with overlying ulceration. Skin biopsy and aspiration of joint fluid excluded calciphylaxis, and confirmed that the patient had urate deposits (tophi)-ie, gout. Microscopy with polarised light showed negatively birefringent urate crystals. The serum concentration of urate was 530 mumol / L (normal concentration 60-360 mumol / L). We prescribed allopurinol. Gout mainly affects men, but this predominance is less pronounced among elderly people-in whom gout usually affects more than one joint, often affects the hand, and tends to develop gradually, with fewer acute attacks than in younger people. Nonetheless, painless gout is rare.

    The accompanying picture (remember this is painless) has the caption:

    (A) The swollen interphalangeal joint. (B) Negatively birefringent crystals. Birefringence is double refraction, and occurs with materials that are anisotropic: they scatter light unevenly. In pseudogout, joints contain positively birefringent crystals of calcium pyrophosphate dihydrate.

    Painless Gouty Finger


    Be thankful. I've had gout for many years and remember long ago when I would have swollen ankles with little pain but through the years the pain grew with every attack. Most on this site will tell you that there is NO WORST PAIN then gout. If you can get control of it now please do so. Trust me you don't want to find out what the pain can be.

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