Gouty hand. Coloured X-ray of a gouty hand. At bottom centre the carpels (wrist bones) are coloured yellow and red. The metacarpels (bones which make up the palm) are at lower centre and are coloured mainly red. The phalanges (finger bones) at upper centre are coloured mainly blue. The joints between the `metacarpels and the phalanges (at centre) have become swollen and misaligned. Gout (arthritis urica) is caused by a faulty metabolism producing too much uric acid. This is often caused by a diet high in protein, malt wine and liquors. The symptoms are painful swelling around the joints. The treatment is rest and a low protein diet with a high water intake.