Why does gout cause ankle swelling?

Gout develops when urate crystals collect in a joint or surrounding tissue. The immune system reacts to the crystals, releasing inflammatory signals. Blood vessels become more leaky and extra fluid enters the area, producing puffiness, tenderness and restricted movement. The ankle may feel tight inside a shoe and the skin can become sensitive. Ankle swelling can also result from injury, infection, circulation problems or other forms of arthritis, so the symptom alone does not establish the cause.

Rest the ankle from impact and elevate it when sitting. Keep movement gentle and avoid forcing the joint through pain. A cool pack wrapped in cloth may ease discomfort for a short time. Contact a clinician promptly about treatment, especially if this is your first episode or the swelling is substantial. Take prescribed gout medicine exactly as directed and do not start, stop or change medicines without advice. Hydration and a record of foods, alcohol, medicines and recent illness may help your clinician identify triggers, but they do not replace treatment.

Seek urgent medical attention for a hot, very painful swollen ankle with fever, chills or feeling unwell, because a joint infection can require immediate treatment. Arrange review if swelling follows an injury, you cannot bear weight, the foot becomes numb or pale, or episodes recur. A clinician may examine the joint and sometimes test joint fluid to distinguish gout from infection or another inflammatory condition.

How can we tell gout from infection or injury? What should I do at the first sign of a flare? Could any of my medicines affect urate levels? How should I protect the ankle while it settles?