Symptoms of gout
The symptoms of gout are caused by the accumulation of uric acid crystals in the joints, in particular at the base of the hallux.
INDEX
What is that?
Who is affected?
Causes
Signs and symptoms
Diagnosis
Therapy and natural remedies
Diet and nutrition
drugs
Complications
Prevention
Healing times
This disease is characterized by a high level of uric acid in the blood (hyperuricemia), it is painful, chronic and progressive.
Gout, accumulation, crystals, acid, uric acid, articulation, arthritis, hallux
Gout
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Gout is hereditary and is not contagious.
This disease mainly affects adults and the elderly, rarely diagnoses in children.
The uric acid crystals can be deposited in small pockets filled with liquid (bags) around the joints.
These crystals increase the inflammation which causes pain and swelling around the joints (bursitis). In rare cases, gout evolves into a type of chronic joint inflammation similar to rheumatoid arthritis.
In chronic gout, uric acid crystals are deposited in different areas of the soft tissues of the body: around the fingers, elbows, ears and around the big toe. These nodules can appear anywhere in the body, in fact they have been reported in unexpected areas such as vocal cords or around the spinal cord.
What is gout?
Gout is a disease caused by an overload of uric acid in the body. This overload causes the formation of small crystals of uric acid that are deposited in the body tissues, especially in the joints.
When crystals accumulate in the joints they cause recurrent inflammation of the joints (arthritis).
Gout is often caused by a hereditary abnormality in the body's ability to metabolize uric acid.
Uric acid is a product of the degradation of purines (a substance found in proteins and DNA) that make up many foods we eat.
An excess of uric acid can cause painful arthritis attacks (gout attack), but it can also affect the viscera, especially the kidneys.
The consequence may be kidney stones and renal failure.
Warning, some people may have high uric acid values in the blood (hyperuricemia) without having the symptoms of gout, such as arthritis or renal failure.
Asymptomatic hyperuricemia occurs when there are elevated levels of uric acid in the blood without symptoms.
The level of uric acid in the blood is often lowered during an acute gout attack.
Asymptomatic hyperuricemia is considered a precursor state for the development of gout.
Arthritis attacks are extremely painful and cause rapid joint inflammation.
Inflammation of the joints is due to the deposit of uric acid crystals in the synovial fluid and in the lining of the joint (synovial membrane).
Inflammation of the joints is the normal reaction of the immune system that sends white blood cells to eliminate uric acid and releases the chemical mediators of inflammation that cause pain, heat and redness around the joint.
This pathology develops with more frequent pain attacks and extends to other joints.
Who is affected by gout?
Over 8 million people in the United States suffer from gout.
Gout is nine times more common in men than in women.
It affects males after puberty, with a peak around 75 years.
In women, gout attacks usually occur after menopause.
About 10% of the male population in the United States have hyperuricemia.
However, only a small part of those with hyperuricemia develop gout.
Causes of gout
In addition to the hereditary anomaly due to the management of uric acid, other risk factors are:
obesity,
weight gain,
alcohol consumption,
fructose intake and corn syrup in non-alcoholic beverages as well as kidney problems.
Gout, arthritis, hallux, inflammation, uric acid
Some medications such as thiazide diuretics (Hydrochlorothiazide), low-dose aspirin, cyclosporine and tuberculosis drugs can cause high levels of uric acid in the blood and lead to gout.
Very strong attacks of the disease are accelerated by:
alcohol intake,
recent trauma or surgery.
Even some diseases can cause excessive production of uric acid in the body. Some examples are: leukemia and lymphoma.
One study showed a decrease in hormone thyroid levels (hypothyroidism) in patients with gout.
Gout attacks can be caused by recent surgery due to blood loss.
How does gout manifest? Signs and symptoms
The big toe is the part of the body that undergoes an attack of acute gout more often, it is called podagra.
Among the joints affected most often there are:
Feet,
ankle,
knees,
wrists,
Fingers,
Elbows.
Acute attacks are characterized by sudden pain in the affected joint along with swelling, heat and redness of the skin.
Gout can also be polyarticular, ie it involves several joints simultaneously.
Patients may also have a fever.
These painful attacks usually regress after a few days, with or without medication. In rare cases, an acute gout attack may last for a few weeks.
The majority of patients with gout had a recurrence of acute arthritis in life.
Gout is suspected when a patient suffers from arthritis attacks, especially at the base of his toes.
The ankles and knees are among the most involved joints.
Usually, this pathology manifests itself in one joint at a time, while other types of arthritis, such as systemic lupus and rheumatoid arthritis, involve multiple joints simultaneously.
X-ray, foot
X-rays can be useful to show crystal deposits, damage due to chronic inflammation and to evaluate the effects of chronic gout on the joints.
The most useful diagnostic test is arthrocentesis, that is the aspiration of the joint fluid to understand if there are any crystals in the joints.
Arthrocentesis is a procedure performed under local anesthesia.
Using a syringe and a sterile needle, the liquid is aspirated from the inflamed joint. The fluid is analyzed to look for uric acid crystals and for potential infections.
The uric acid crystals are visualized with a microscope.
The diagnosis of gout can be made by finding these urate crystals in the material aspirated by the joint nodules and by the fluid of the bursitis.
Rheumatologists are the experts who are experts in this evaluation.
Patients with a classic history and symptoms of gout can be properly treated without having to do arthrocentesis.
However, getting to a correct diagnosis is difficult because other disorders can be similar to gout such as pseudogout, psoriatic arthritis, rheumatoid arthritis and even joint infections.
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