Junior gout.

Is it rare for a 40-something man to have gout?

Michael Earl, Atlanta, Georgia

Not at all. In fact, men who develop gout (a painful form of chronic arthritis) often experience their first attack between age 30 and 50. Gout occurs when excess uric acid in the bloodstream crystallizes within joints and causes painful swelling. Middle-aged men are more at risk than their female counterparts because they have higher uric acid levels. Other contributors include overeating and alcohol use. In people over 60, when gout occurs equally in men and women, kidney problems are its most common cause.

Gout cases are on the rise in the U.S. with an estimated 8 million people diagnosed each year. An initial attack typically causes pain in the big toe for a couple of days. But subsequent flareups tend to last longer and can affect ankles, knees, hands, or elbows. Anti-inflammatories and the prescription drug colchicine (a derivative of the autumn crocus) can help.