Lay summary
Gout is a painful arthritis caused by urate crystals that form in the joints of people with high blood urate levels. A fundamental question in understanding the cause of gout is why some individuals with high blood urate levels develop gout and others do not. In some people with high blood urate levels, imaging tests such as ultrasound can detect urate crystals in the joint. We are planning a large, New Zealand-led, international study of people with high urate levels to understand whether the presence of these changes on ultrasound predict development of gout over a five year period. Results of the study will provide clinically-relevant information about risk factors for gout in people with elevated serum urate concentrations that can be used to guide discussions with individuals about their risk of disease. The study will also identify potential strategies to reduce the risk of gout.