The main causes of gout can be attributed to a high level of uric acid in the blood. The high level is due to the metabolism (breakdown) of purines that exist in the body, mainly from the foods we eat. If the kidneys are not working properly, the uric acid builds up forming monosodium uric acid crystals that deposit in the joints and surrounding soft tissues (tophi). This causes extreme pain, swelling, and inflammation of the affected area. Other causes of gout can include: lymphoma, some cancers, psoriasis, diabetes and hypertension.