All About Gout

Content

• Diseases And Disorders That Increase The Risk Of Gout
• Gout Diagnosis And Management: Updated Treatment Guidelines
• Risk Factors For Gout
• Medical Encyclopedia

The best uric acid level for a person with gout is below 6.0 mg/dL—regardless of age or gender. Gout attacks typically occur suddenly with no warning. The affected joint can become hot, red, swollen, and tender within just a few hours. Some patients describe the pain as unbearable, even when so little as a sheet touches the joint, and severe attacks may last for hours to weeks. Once the attack subsides and symptoms are no longer present, patients usually do not experience pain until the next flare.

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.

Diseases And Disorders That Increase The Risk Of Gout

Colchicine may interact with other commonly prescribed drugs, such as atorvastatin and erythromycin, among others. Gout on X-rays of a left foot in the metatarsal-phalangeal joint of the big toe. Note also the soft tissue swelling at the lateral border of the foot.

Some experience pain so intense that even the light touch of a bed sheet on the joint is excruciating. These painful attacks can last from hours to several days. In cases of chronic inflammation, the attack may last for weeks. Unfortunately, patients with gout are at risk for repeated attacks of gouty arthritis. Sometimes during an acute gout attack, uric acid levels may test normal because the uric acid has left your bloodstream and entered the inflamed tissue.

Gout Diagnosis And Management: Updated Treatment Guidelines

The most important symptoms of gout are pain and swelling, which may be accompanied by systemic symptoms such as fever and malaise. Nonsteroidal anti-inflammatory drugs, corticosteroids, and colchicine are effective treatments for acute gout. With attacks of gout in multiple joints an injectable medicine called anakinra may be used. But, not everyone with a high uric acid level has gout. Corticosteroids reduce pain from a gout attack as well as NSAIDs do. NSAIDs reduce pain from a gout attack.All NSAIDs work as well as each other to reduce pain.

It most often occurs in one or both of your big toes. It can affect your feet, ankles, fingers, wrists, elbows, and knees as well. Women are more likely to develop gout aftermenopause. Gout can be acute (short-lasting) or chronic (long-lasting). Doctors remove fluid from the joint and check it for uric acid crystals to confirm the diagnosis of gouty arthritis.

Related Health Topics

It may also be associated with thyroid conditions such as hypo- or hyperthyroidism. Diagnosis of pseudogout takes these factors into consideration, and can include collecting a sample of joint fluid to look for the presence of calcium pyrophosphate dihydrate crystals. Occasionally, polyarticular tophaceous gout presents as subcutaneous nodules that can mimic rheumatoid arthritis. In this case, the presence of monosodium urate crystals in the nodule aspirate can confirm gout. Acute gout sometimes resembles cellulitis and can lead to skin desquamation over the inflamed area. Gout can also cause acute bursitis or tenosynovitis of periarticular structures.

What does gout pain feel like?

If you have gout, you'll probably feel swelling and pain in the joints of your foot, particularly your big toe. Sudden and intense pain, or gout attacks, can make it feel like your foot is on fire.

Drugs such as cyclosporine, thiazide diuretics , and salicylates can interfere with uric acid excretion as can excessive consumption of alcohol. Your risk of gout goes up when your diet is high in naturally occurring compounds called purines. When purines break down in the body, they cause uric acid to form. In most cases, people who have gout will still need medication even when they follow a diet for gout. That said, tweaking your diet can be a powerful way to help manage gout and gout symptoms. Some research suggests that food changes alone can lower your uric acid levels by up to 15 percent, according to theInstitute for Quality and Efficiency in Health Care.

Prevention Tips

Elevated risk has been reportd with recombinant zoster vaccine and other vaccine, but not influenza vaccine. Causes of secondary gout due to underexcretion of uric acid include renal insufficiency, lead nephropathy , starvation or dehydration, certain drugs, and chronic abuse of ethanol . These disorders should be identified and corrected, if possible. Gout is definitively diagnosed on the basis of demonstration of urate crystals in aspirated synovial fluid, in the absence of another etiology for arthritis. Classic radiographic findings are highly suggestive .

Risk Factors For Gout

Gout is a picturesque presentation of uric acid disturbance. It is the most well understood and described type of arthritis. New insights into the pathophysiology of hyperuricemia and gouty arthritis; acute and chronic allow for an even better understanding of the disease. The role of genetic predisposition is becoming more evident. The clinical picture of gout is divided into asymptomatic hyperuricemia, acute gouty arthritis, intercritical period, and chronic tophaceous gout.