What Is Gout? Symptoms, Causes, Treatment, Medication, Diet, Remedies

Content

• Mywakehealth
• Gout And Kidney Disease
• What Are Risk Factors For Pseudogout?
• Pseudogout

It also can affect other joints such as the knee, ankle, foot, hand, wrist and elbow. In rare cases, it may later affect the shoulders, hips or spine. , deposits, including tophi, may begin to dissolve and become less visible over months. Gout may mimic and is sometimes misdiagnosed as another type of arthritis.

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Search for opportunities to participate in a clinical research study. Get the latest scientific news and resources on diseases of the bones, joints, muscles, and skin from the NIAMS. Elevating the affected limb, if possible, to help reduce swelling. Dietitians, who can teach you about how to follow a healthy diet to improve your health. Care for other conditions or complications that happen with gout.

Gout And Kidney Disease

To further add to the confusion, both conditions can cause you to develop a fever and for your white blood cell count to spike. In either instance, your body thinks you have an infection it’s trying to fight off, but in only one of those cases is an infection present. About 25 percent of patients with gout feel pain in multiple joints, and the toe isn’t necessarily one of them.

How painful is the gout?

Intense joint pain.
Gout usually affects the big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins.

Gout is caused by monosodium urate monohydrate crystals; pseudogout is caused by calcium pyrophosphate crystals and is more accurately termed calcium pyrophosphate disease . (See Pathophysiology and Etiology.) Gout is one of the oldest diseases in the medical literature, known since the time of the ancient Greeks. Pseudogout, which may be clinically indistinguishable from gout, was recognized as a distinct disease entity in 1962. Adverse effects include rash, precipitation of acute gouty arthritis, GI intolerance, and uric acid stones.

What Are Risk Factors For Pseudogout?

When fluid is examined from an inflamed joint in pseudogout, the specific causative crystal can be seen. In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed. There is no treatment that can eliminate the calcium pyrophosphate crystals in your joint once you’ve developed pseudogout.

Removing fluid containing the crystals from the joint can reduce pain and help the inflammation to diminish more quickly. Cortisone injected into an inflamed joint will also help decrease the inflammation. Colchicine is a medication used to decrease inflammation in patients with gout and may also be helpful in pseudogout. Corticosteroids taken as a pill can help if the patient can't tolerate colchicine or NSAIDs. Gout is often diagnosed upon the finding of uric acid based crystals.

White cell counts can range from a few thousand cells up to 80,000 to 100,000 per high-power field. Although some food and beverages are associated with hyperuricemia and gouty attacks, dietary factors are not sufficient to explain most gout attacks. To confirm or rule out infection, the fluid needs to be processed by Gram stain and culture.

Uric acid crystals can build up and develop swellings and bumps called tophi. X-rays of the affected joints may show uric acid deposits and damage indicative of gouty arthritis. If you experience sudden, intense pain in a joint, see your doctor for a diagnosis.

Treatment

Tophi often are found in or near severely affected joints on or near the elbow, over the fingers and toes and in the outer edge of the ear. If the tophi are not prevented or treated, they can damage joints . Gout is a dramatic example of a type of arthritis called crystal arthritis, sometimes called microcrystalline arthritis because the crystals are very small. As the body tries to remove the crystals, a painful inflammation occurs. The diagnosis of gout is usually confirmed when uric acid crystals are identified in a sample of a tophus or in joint fluid removed with a needle and viewed under a special microscope with polarized light. In people with gout who also have another disorder that damages the kidneys , increasingly poor kidney function reduces the excretion of uric acid and makes the gout and its joint damage progressively worse.

How is Pseudogout different from gout?

While gout is caused by uric acid crystals; pseudogout is caused by calcium pyrophosphate dehydrate crystals (CPPD). And though the two have similar symptoms, treatment is somewhat different. Pseudogout causes sudden attacks of joint pain, swelling, and warmth. The attacks can last for days to weeks.

The symptoms are similar to the symptoms of other diseases, especially gout (which is why this form of arthritis had the old name of pseudogout – “false gout”). Some symptoms of CPPD may appear to be symptoms of rheumatoid arthritis or osteoarthritis. For acute attacks of gout, a key is treating as quickly as possible and choosing a medication least likely to cause side-effects, with special attention to individual co-morbidities. For chronic prevention of gout, the essential message is that present treatments work in a huge majority of patients, and are generally well-tolerated.

Pseudogout

In people with gout, the first episode of inflammation usually affects the big toe or other joints in the foot or ankle. If urate levels remain high, flares can recur, affecting additional joints throughout the body. The time between flares varies among affected individuals; however, most people who experience multiple flares have their second one within a year of their first. The majority of people with deposits of calcium pyrophosphate dihydrate crystals in their joints never develop symptoms of pseudogout. While gout is caused by the deposition of uric acid crystals, pseudogout is caused by calcium pyrophosphate dihydrate crystals. •Almost all plasma urate is filtered at glomerulus; only a small amount bound to protein is not filtered.

If you are also running a fever, you may have an infection. Many people with gout are also diabetic and are at greater risk for infection. Gout is more common in men than in women and hits men at a younger age. Women do not typically develop gout until after menopause, between the ages of 55 and 70.

How Is Calcium Pyrophosphate Dihydrate Crystal Deposition Disease Cppd, Or Pseudogout Diagnosed?

Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. Verywell Health's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. JEFFREY A. ALLOWAY, M.D., is a rheumatologist at Wilford Hall USAF Medical Center at Lackland Air Force Base and assistant professor of medicine at the USUHS F. Edward Hébert School of Medicine. LORI B. SIEGEL, M.D., is chief of rheumatology at the Finch University of Health Sciences, Chicago Medical School.