Gout is a monosodium urate crystal deposit disease, occurring as a consequence of hyperuricemia. Very
importantly, the formation of crystals is reversible and they slowly dissolve when serum urate levels became
normal, so the disease can be considered curable. The identifi cation of urate crystals in synovial fl uid allowssi mple unequivocal diagnosis; diagnosis based on clinical features and hyperuricemia is often inaccurate, even if patients fi t the American College for Rheumatology Classifi cation Criteria. Several recent publications show that gout is frequently misdiagnosed, and management often falls below reasonable standards. The main aim of treatment is to dissolve the deposited crystals, freeing the patient of the disease; this is usually achieved by allopurinol, and new drugs will be available soon. Crystal deposit is silent but signaled by the occurrence of gouty attacks, for which treatment is effective, and can be avoided with adequate prophylaxis. Alterations related to the so-called metabolic syndrome (such as high blood pressure, insulin resistance, dyslipidemia, abdominal obesity and propensity to atherosclerosis) are often signaled by gout, and require proper attention.