If you have arrived on this page looking for gout in the shoulder and pain information, please note this is our PAGE 2 about shoulder gout. Best to read page 1 first. Then return here
This page about gout in the shoulder was first reviewed or updated on 14 August 2018
CAUSES OF SHOULDER GOUT
Do you get shoulder gout in any special way?
Not really. You could be prone to it if you already have gout and if you have had a previous non-gout injury to a shoulder. Shoulder gout is regular gout from the usual causes. Or you might develop shoulder gout because you played a sport which involved using your shoulder and arms a lot. Or from your job.
Nor as far as is presently known, is there a special gene causing it. In gout's mysterious way, it just shows up there, usually with people who have had gout for a long time. Most shoulder gout patients have gout in some other places – wrists, knees, ankles, toes etc.
So it is much more likely you would suffer shoulder gout as a second, third or fourth etc. spot in the body with an attack, than as the first.
ROTATOR CUFF GOUT
Gout usually attacks joints – in the shoulder the glenohumeral joint, its main one. Rheumatoid arthritis is the most common disorder of this joint. not gout or pseudo gout.
Gout would usually attack a joint. However, there are three studies (1) (2) (3), where it attacked the shoulder’s rotator cuff. The rotator cuff is a group of four muscle tendons in the shoulder that were affected by gout’s crystals in these cases. The four are involved in arm movement. In one study tophi was found on one side of a rotator cuff tendon. It was removed surgically. In a second study it was found in the same tendon and also successfully dealt with. In both studies, tophi caused the patient limited shoulder movement
Rotator cuff problems are also another common cause of shoulder pain.
BEWARE OF TOPHI IN THE SHOULDER
Tophi are knobbly-shaped chalky-like lumps, the accumulation of the MSU crystals which themselves form (sometimes, not always) when the concentration of uric acid in serum (blood) increases to the gout causing level.
Tophi can jam up the glenohumeral joint in the shoulder, and that makes you unable to move your arm or have limited movement.
In the two studies mentioned above, gout in the rotator cuff in the shoulder developed into tophi gout. But tophi usually forms in joints.
What makes tophi development somewhat more likely in the shoulder is that although tophi can take a few years to develop, it can also take a long time to diagnose shoulder gout. Tophi might grow whilst you wait to find out exactly what you suffer from. Perhaps the only “good thing” about tophi is that it can be seen on a scan which helps to confirm gout.
So if you develop tophi at least gout is finally confirmed !
HOW YOU CONTROL SHOULDER GOUT
There is no special treatment for gout in the shoulder. You do the usual things aimed at getting uric acid down to below 5.5 - 6.0 mg/dL. In the long run you must keep it at least at the level it was when shoulder gout and other gout attacks ceased.
Gout in the shoulder patients have been fixed with the common drugs for gout, allopurinol and colchicine. But you might have to use a biologic gout drug such as Krystexxa to attempt to get uric acid down fast to start getting rid of tophi and controlling gout in the shoulder . Or you might have to have a operation to physically remove the tophi. That means finding a hospital with the experience to do it.
Gout in the shoulder tip If you have shoulder pain and fear it might be gout, get an expert diagnosis as soon as you can. Don’t let it drag on because if tophi develop you have more problems. A rheumatologist dealing with gout patients, and hopefully gout in the shoulder patients, is probably your best bet.
VIDEO > This YouTube video is about the five main types of shoulder joint arthritis, including gout and pseudo gout. Note that arthritis is not the only shoulder affliction. And that gout is considered to be a type of arthritis.
(NB The video is for education not medical advice)
CONTACT US ABOUT SHOULDER GOUT
Shoulder gout is a somewhat under researched and written topic in gout. If you have suffered from it, or thought you did, please use the form below to send us details which we can present to our visitors.
(1) O'Leary ST, Goldberg JA, Walsh WR Tophaceous gout of the rotator cuff: a case report. J Shoulder Elbow Surgery.2003 Mar-Apr;12(2):200-1.
(2) Chang, Chih-Hao MD; Lu, Chia-Hung MD; Yu, Chih-Wei MD; Wu, Mu-Zon MD; Hsu, Chao-Yu MD; Shih, Tiffany Ting-Fang MD Tophaceous Gout of the Rotator Cuff: A Case Report The Journal of Bone and Joint Surgery-American Volume: January 2008 - Volume 90 - Issue 1 - p 178-182 doi: 10.2106/JBJS.G.00
(3) Filippucci E, Delle Sedie A, Riente L, Di Geso L, Carli L, Ceccarelli F, Sakellariou G, Iagnocco A, Grassi W. Ultrasound imaging for the rheumatologist. XLVII. Ultrasound of the shoulder in patients with gout and calcium pyrophosphate deposition disease. Clin Exp Rheumatol. 2013 Sep-Oct;31(5):659-64. Epub 2013 Sep 18