From the Guidelines
Yes, gout in the right knee can cause fever and a mildly elevated white blood cell count. Gout is a form of inflammatory arthritis caused by high levels of uric acid in the blood, which forms crystals in joints. During an acute gout attack, the body mounts an inflammatory response against these crystals, which can lead to systemic symptoms including low-grade fever (typically 99-101°F) and a mild elevation in white blood cells 1. This occurs because the immune system is activated to fight what it perceives as a foreign substance. The inflammatory process releases cytokines and other inflammatory mediators that can trigger these systemic responses.
These symptoms are more common in severe gout attacks or when multiple joints are involved. If you're experiencing these symptoms with knee pain, redness, and swelling, it's essential to seek medical evaluation to confirm the diagnosis of gout and rule out other conditions like infection. According to the 2012 American College of Rheumatology guidelines for management of gout, treatment typically includes anti-inflammatory medications such as colchicine, NSAIDs like indomethacin or naproxen, or corticosteroids to reduce inflammation and pain 1.
Key points to consider in the management of gout include:
- Initiating pharmacologic therapy within 24 hours of acute gout attack onset
- Not interrupting ongoing pharmacologic ULT during an acute gout attack
- Using NSAIDs, corticosteroids, or oral colchicine as appropriate first-line options for treatment of acute gout
- Considering pharmacologic anti-inflammatory prophylaxis for all gout patients when pharmacologic urate-lowering is initiated 1.
It's crucial to prioritize the patient's quality of life, morbidity, and mortality when making treatment decisions, and to individualize treatment based on the patient's specific needs and circumstances.
From the FDA Drug Label
Indomethacin capsules have been found effective in relieving the pain, reducing the fever, swelling, redness, and tenderness of acute gouty arthritis
The answer to the question is yes, right knee gout can cause someone to have a fever. However, regarding the mild elevated white cell count, there is no direct information in the provided drug labels that supports this specific symptom as a direct result of right knee gout. Therefore, no conclusion can be drawn about the white cell count. 2
From the Research
Gout and Systemic Symptoms
- Gout is a form of acute inflammatory arthritis caused by the deposition of monosodium urate crystals within the synovium of joints, leading to severe pain and reduced quality of life 3, 4.
- The condition is characterized by swelling, pain, or tenderness in a peripheral joint or bursa, including the development of a tophus 3.
Fever and Elevated White Cell Count
- Advanced erosive gout can be a cause of fever of unknown origin, as illustrated by a case report of a 61-year-old man with a 3-month history of fever and joint pains, who was diagnosed with gout after arthrocentesis revealed uric acid crystals 5.
- Gout can also cause a markedly elevated intra-articular white cell count, with reported cases of cell counts greater than 50,000 white blood cells/µL in the absence of infection 6.
- In some cases, the white cell count can be extremely high, with reported counts of up to 500,000 white blood cells/µL, making it difficult to differentiate between acute gout and septic arthritis 6.
Right Knee Gout and Systemic Symptoms
- While the provided studies do not specifically address the question of whether right knee gout can cause fever and mild elevated white cell count, the evidence suggests that gout can cause systemic symptoms such as fever and elevated white cell count, particularly in cases of advanced erosive gout 5, 6.
- Therefore, it is possible that right knee gout could cause fever and mild elevated white cell count, although the severity and likelihood of these symptoms may vary depending on the individual case and the presence of other underlying conditions 3, 4.