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Gout

• Gout is a type of arthritis that causes inflammation, usually in one joint, that begins suddenly.
• Gouty arthritis is caused by the deposition of needle-like crystals of uric acid in a joint.
• Gout symptoms and signs include
     ○ nodules under the skin called tophi,
     ○ joint redness,
     ○ swollen joints,
     ○ joint pain, and
     ○ the warmth of the joint.
• The most reliable method to diagnose gout is to have fluid removed from an inflamed joint and examined under a microscope for urate crystals.
• Chronic gout is treated using medications that lower the uric acid level in the body.
• Gout can cause irreversible joint damage, kidney problems, and tophi.
• Triggers for acute attacks (flare-ups) of gout include surgery, dehydration, beverages sweetened with sugar or high fructose corn syrup, beer, liquor, red meat, and seafood.
• Cherries may help prevent gout attacks.

What is gout?

Gout is a type of arthritis that causes sudden joint inflammation, usually in a single joint. Severe gout can sometimes affect many joints at once. This is known as polyarticular gout.

What causes gout?

Gout is caused by too much uric acid in the bloodstream and accumulation of urate crystals in tissues of the body. Uric acid crystal deposits in the joint cause inflammation of the joints leading to pain, redness, heat, and swelling. Uric acid is usually found in the body as a byproduct of how the body breaks down specific proteins called purines. Causes of an elevated blood uric acid level (hyperuricemia) include genetics, obesity, certain medications such as diuretics (water pills), and chronic decreased kidney function (kidney disease).

What are the risk factors for gout?

There are many risk factors for gout. Having high blood pressure is a risk factor for gout. Gout is more common after surgery, trauma, and dehydration. Certain medications, such as diuretics (commonly known as water pills), which treat high blood pressure that raises the level of uric acid in the bloodstream, are risks for gout. Surprisingly, medications that lower the level of uric acid in the bloodstream, such as allopurinol (Zyloprim, Aloprim), can also initially cause a flare of gout. This is because anything that increases or lowers the uric acid level can cause a gout flare, causing uric acid crystals to be deposited in a joint. Low-dose aspirin can precipitate gout attacks. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed. Degenerative arthritis also makes affected joints more likely to be the site of a gouty attack.

What are gout symptoms and signs?

The characteristic symptoms and signs of gout are
• sudden onset of joint pain,
• joint swelling,
• heat in the affected area, and
• joint redness.

These symptoms and signs usually affect a single joint. The pain is typically severe, reflecting the severity of inflammation in the joint. The affected joint is often susceptible to touch to the point that some people with gout attacks experience pain from something as simple as pulling the bedsheets over the inflamed joint. The affected joint becomes swollen. The medical term for excessive fluid in a joint is a “joint effusion.”

Gout frequently involves joints in the lower extremities. The preferred location for gout to occur is the big toe (first metatarsophalangeal joint). Podagra is the medical term for inflammation at the base of the big toe. Gout can also affect the foot, knee, ankle, elbow, wrist, hands, or nearly any joint. When gout is more severe or longstanding, multiple joints may be affected at the same time. This causes pain and joint stiffness in various joints.

Another sign of gout is the presence of tophi. A tophus is a hard nodule of uric acid that deposits under the skin. Tophi can be found in various locations in the body, commonly on the elbows, upper ear cartilage, and on the surface of other joints. When a tophus is present, it indicates that the body is substantially overloaded with uric acid. When tophi are present, the uric acid level in the bloodstream typically has been high for years. The presence of tophi indicates tophaceous gout, and treatment with medications is necessary.

Longstanding untreated gout can lead to joint damage and physical deformity.

Kidney stones may be a sign of gout as uric acid crystals can deposit in the kidney and cause kidney stones.

Gout Diet

The primary dietary goal for gout is to limit your intake of foods with high amounts of purine. Ideally, you will have little or no foods that are high in purine and only small amounts of those with moderate amounts of purine.

Foods considered high in purine content include the following:
• Some fish, seafood, and shellfish, including anchovies, sardines, mackerel, scallops, herring, mussels, codfish, trout, and haddock
• Some meats such as bacon, turkey, veal, venison, liver, beef kidney, brain, and sweetbreads
• Alcoholic beverages

MEDICAL DISCLAIMER:

By reading this website, you acknowledge that you are responsible for your own health decisions. The information throughout this medical website is not intended to be taken as medical advice. The information provided is intended for general information regarding our Podiatry clinic in Brooklyn and the best Foot and Ankle Care Services. If you are interested in finding out more, avoid worrisome self-diagnosis, please contact our Podiatry specialist for a personal consultation. No information on this site should be used to diagnose, treat, prevent, or cure any disease or condition.