Gout

What is gout?

This is a type of arthritis that is caused by Uric acid crystal building up in the joint. This disease can cause the destruction of the joint and lead to very painful gout attacks. Gout attacks can occur in any joint but usually occur in the big toe joint. The attacks can happen every few weeks, months or even years. The gout attack lasts approximately 7 days. There is extreme pain noted to the joint during that time. Proper management of this condition is necessary to prevent joint destruction, tendon tears and soft tissue atrophy and surgery.

foot gout

This is a form of arthritis. It causes pain and swelling in your joints. For many people, it starts in the big toe.

What Causes Gout?

Gout is caused by the precipitation of uric acid crystals in the joint

Factors that increase precipitation of gout are:

  • Increased serum uric acid levels due to overproduction or underexcretion 
  • Overweight
  • Diets that are high in purines such as: meats, seafood, spinach, alcohol
  • Trauma
  • Medication such as diuretics
  • Dehydration

 

What are the Symptoms of Gout?

Symptoms of gout include:

  • Sudden onset 
  • Extreme pain
  • Redness swelling to the big toe, and other joints of foot and ankle
  • Nodules around the joint
  • In extreme cases white fluid being extruded from the joint
  • Symptoms may last a few days to several weeks

 

How to Diagnose Gout?

Diagnosis of gout is done by:

  • Taking X-ray to look for joint destruction and arthritic changes and tophi (gout crystals)
  • Physical exam to look for findings consistent with gout
  • Joint aspiration and confirming on pathology for proper treatment protocol

How to Treat Gout?

Treatment is divided into treating the acute symptoms first and then the chronic long term nature of gout

Acute treatment includes:

  • Anti-inflammatory medication
  • Corticosteroid oral medication or intra articular injection

Long term care:

  • Patient education with emphasis on diet and overall health to reduce the frequency of gout attacks
  • Medication that lower Uric acid levels: the type of medication with depend on the why patient has elevated uric acid levels
  • Proper shoe gear and orthotics for better pressure distribution to prevent crystallization of the uric acid.