Some types of arthritis present only in one or two joints. Gouty arthritis is one of these. About half of cases are located in the big toe (in this case it is sometimes known as podagra), with the wrists, knees and heels being other joints commonly affected.
Gouty arthritis is different that other forms in a number of ways. For one, it usually comes in attacks. There may be no pain or swelling for a period of time, then over the course of a few hours the joint begins to hurt and usually will hurt through the night, due to the natural decrease in body temperature at that time.
With gout is an attack of acute inflammatory arthritis in which the joint is painful and possibly swollen. It can also be red, tender and hot to the touch. These are usually the only symptoms, although some may experience fatigue and fever.
Also unlike other types of arthritis, gout has a very specific source. When the level of uric acid in the blood are elevated (hyperuricemia), the acid can crystallize. These crystals then deposit in the joints and tendons and around the tissues, causing problems in those areas. This is why there may also be other related issues such as kidney stones or urate nephropathy.
Tophi are another issue that can occur. A tophus is a round protrusion of the skin due to an accumulation of monosodium urate crystals. The form when gout goes untreated for 5-10 years and can form in the joints, cartilage or bones and are treated as gout itself is treated.
Diet can account for the onset of gout in about 12% of cases. Usually this is because of increased alcohol intake, meat, seafood and fructose-sweetened drinks. Avoiding these types of foods can help to get the uric acid levels into a normal range, meaning a decrease or avoidance of gouty episodes.
Some foods can actually decrease the risk of developing gout. The reason for this may be because they have the effect of reducing insulin resistance. Drinking coffee is one of them. Other foods are dairy products and foods high in vitamin C. For the same reason, being physically fit is also a great benefit.
Genetics can also be a factor when it comes to gouty arthritis. There are three genes associated with gout, and they and variations of them can mean a doubling of the risk of getting gout. They may contribute to a reduction in urate absorption or allow excessive urate secretion.
Gout can also be brought on as a part of other disorders. There are a variety of medical problems that can lead to symptoms of gout, as the body is unable to process and work with variable in the most constructive way.
Diagnosing gout can be very simple if there are classic podagra symptoms or a known instance of hyperuricemia. In these cases it is not necessary to take further tests, and treatment can begin right away. If these conditions aren’t present, however, more will be required to diagnose gout.
There are a few tests that might be taken in order to make a diagnosis. One of these is to take samples of fluid from the inflamed joints and to check them for crystals. This test requires a well-trained doctor and must be examined soon after removal. Although difficult, this is the most sure test.
In half of the cases of gout, hyperuricemia is present. This can be identified through blood tests which measure the level of uric acid as well as counting of the white blood cells, and other constituents. This test is simpler but less sure an indicator of gout.
As mentioned previously, diet can affect gout, and avoiding certain foods and consuming others can make a difference and can even prevent gout. Avoiding obesity is also a good way to reduce the risk. Sleep apnea is another issue. As the cells are deprived of oxygen, purines are released which can also bring on gout. Treating sleep apnea can help to treat gout as well.
When an attack occurs, the primary goal is to alleviate the symptoms of the attack. This is often done with NSAIDS (non-steroidal anti-inflammatory drugs) such as indomethacin or ibuprofen. There are also a number of prescription drugs that can be given if NSAIDS aren’t tolerated and depending on how effective other treatments have been.
As with any drugs there are side effect to some of the drugs available. They may help to deal with pain or inflammation or decrease the level of uric acid in the system, but they may also cause problems with the stomach or other aspects of health. Stay in close contact with your doctor to determine what is the best course of treatment for you.