All About Gout For Primary Care

Content

• Study Selection
• What Is The Latest Research On Gout?
• Article Level Metrics
• Urgent Ortho Care
• Who Is Affected By Gout?

The selection process and the reasons for study exclusion in each step are depicted in Fig 1. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement . Therefore, no ethical approval or written informed consent was required. The database search, literature selection and assessment, and data extraction were conducted by two investigators independently, and any disagreement was resolved by discussion and consensus. MD helped to plan the study, collected the medical records, analyzed the data, and drafted the manuscript.

Some people can have high levels of uric acid but not enough to experience gout. At the same time, people with physical signs of gout may not have high levels of uric acid in their blood. In some academic centers with appropriate expertise, ultrasonography of the joint with guided aspiration may help to diagnose; a dual-energy CT scan of the affected joint is also available in some centers to diagnose gout.

Study Selection

For patients without classic symptoms, MSU crystal deposition could be identified by image-based examination, such as dual-energy computed tomography and US. It has been reported that the MSU burden volume, which is predictive of the risk of flares , can be measured using DECT . Due to being noninvasive, free of ionizing radiation, convenient, and inexpensive, US is more widely used in the clinic. Our study shows that MSU deposition can be detected by US, and the most frequently affected joint is MTP1 in the gout patients. This result is consistent with clinical findings reported by other groups .

Is a heating pad good for gout?

Research shows that ice is particularly soothing for gout; if you're dealing with a different type of arthritis, a heating pad may be a better choice. Some people also say that eating cherries or drinking tart cherry juice helps during a gout flare.

The left first MP joint is slightly redder, but the dorsum of both feet resembled cellulitis. Interestingly, three of her sons had gout, but no one had ever asked about that. However, people who develop gout may be those at highest risk of side effects from either traditional non-steroidal anti-inflammatory drugs or cyclo-oxygenase-2 inhibitors. The serum urate concentration may reduce during an acute attack; a normal urate concentration at this point does not rule out a diagnosis of gout. Table 2 summarises other suggested investigations for patients with suspected gout.

What Is The Latest Research On Gout?

The type of pain you feel with gout may vary depending on whether you’re experiencing an acute gout episode or a flare-up of chronic gout. Acutegoutusually involves a single joint, and acute gout symptoms typically go away within a few days. People with acute gout may not experience another attack for several months, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Furthermore, follow-up should be recommended to observe the longitudinal changes of ultrasound features along and their relationship with SUA levels. Ultrasound findings of gout include the double contour sign, presence of tophi, and the snowstorm sign which are reported to be specific for gout . The presence of these three features is closely related to the deposition of monosodium urate crystals and is rarely seen in other types of arthritis . This is consistent with the findings of this study, which showed high specificities in the diagnosis of gout using these three features in the person-based evaluations (all exceeded 0.90).

Article Level Metrics

The condition occurs when uric acid levels in the blood increase to the point that the uric acid crystallizes. This leaves needle-like crystal deposits in the joints, tendons and ligaments, which triggers severe inflammation. It is caused by a combination of factors including diet, medication and genetics, and it occurs more commonly in those who consume red meat, drink large amounts of beer and are overweight. Those with chronic arthritis can develop joint deformities and loss of motion in the joints.

Although gout typically affects the big toe, other joints can also be involved. Usually, the first episodes of gout affect only one joint, but as the disease becomes more severe, the episodes can affect several joints at the same time. Men are more likely to get gout, but women become increasingly susceptible to gout after menopause.

It reduces uric acid quickly and to lower levels than other medications. The drug is administered every two weeks by intravenous infusion. Nonsteroidal anti-inflammatory drugs are frequently used to relieve the pain and swelling of an acute gout episode. They can shorten the attack, especially if taken in the first 24 hours.

High fructose intake was linked to gout in a Choi-led study published in 2008. Uric acid is one of the products of fructose metabolism, and there's good evidence from controlled feeding studies that fructose increases uric acid levels in the blood. Much of the fructose in today's American diet comes from the high-fructose corn syrup that's used to sweeten soft drinks and many other foods and drinks. Changes in lifestyle, such as limiting foods associated with gout, should be initiated in anyone who has had gouty attacks. Treatment of gout with medications is necessary when frequent disabling gouty attacks occur, when kidney stones caused by uric acid are present, when there is evidence of joint damage from gout on X-rays, or when tophi are present.

The urate crystals are recognized as foreign and taken up by macrophages, inciting an inflammatory response . For years, gout patients were told they had to follow a purine-restricted diet to stave off attacks, but those diets weren't very effective and people had a difficult time sticking to them. Now the easier-said-than-done advice is to lose weight, and also to cut back on alcohol, especially beer. Big meat and seafood eaters may be told to curb their appetites and instead eat more low-fat dairy foods. If someone with gout is taking one, a doctor might explore lowering the dose or switching to a different medication.

Therapy:

Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels.

Who Is Affected By Gout?

This treatment is positive and it also decreases blood uric acid levels. The acute gout attacks are painful and potentially disabling, needing immediate treatment. The optimal therapy is towards controlling pain and inflammation Drug therapy for gout has become an important part of the therapeutic approach to the disease, which includes lifestyle modifications.

Crystal Arthropathies Including Gout

Administer anti-inflammatory prophylaxis before initiating ULT as ULT may trigger, prolong, or worsen an acute gout flare. It is typically associated with hyperuricemia, but can also occur if uric acid levels are normal. In practice, ultrasound is typically used if you have just begun to experience symptoms or recurrent attacks.