Gout
Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.
Causes
Gout is caused initially by an excess of uric acid in the blood, or hyperuricemia. Uric acid is produced in the body during the breakdown of purines – chemical compounds that are found in high amounts in certain foods such as meat, poultry, and seafood.
Normally, uric acid is dissolved in the blood and is excreted from the body in urine via the kidneys. If too much uric acid is produced, or not enough is excreted, it can build up and form needle-like crystals that trigger inflammation and pain in the joints and surrounding tissue.
Signs and Symptoms
Symptoms of a gout attack may include:
- Sudden, intense pain in a joint, typically the big toe or ankle, sometimes the knee, hand or wrist
- Swelling, inflammation and a feeling that the joint is very hot
- Extreme tenderness of the joint to even the lightest touch
- Red or purple skin around the joint
- In extreme cases alternating chills and fever
- With recurring attacks soft fleshy growths may appear, called tophi, which are accumulations of uric acid crystals.
Diagnosis
A gout attack will usually go away in about 3 to 10 days. But you can feel better sooner if you treat it. To be sure that you have gout, see your doctor. He’ll examine you, and he might do some tests.
These tests help your doctor know if you have gout, or something else with similar symptoms:
- Joint fluid test. Fluid is taken from the painful joint with a needle. The fluid is studied under a microscope to see if the crystals are there.
- Blood test. A blood test can check the level of uric acid. A high level of uric acid doesn’t always mean gout.
- X-ray. Images of the joints will help rule out other problems.
- Ultrasound. This painless test uses sound waves to look areas of uric acid.
Treatment
Gout medications can be used to treat acute attacks and prevent future attacks. Medications can also reduce your risk of complications from gout, such as the development of tophi from urate crystal deposits.
Medications to treat gout attacks
Drugs used to treat acute attacks and prevent future attacks include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Colchicine
Corticosteroids