Summary about Disease
Gouty arthritis, commonly known as gout, is a form of inflammatory arthritis caused by a buildup of uric acid crystals in the joints. This buildup leads to sudden, severe attacks of pain, redness, and swelling in the affected joints, most often the big toe. Gout is a chronic condition that can be managed with medication and lifestyle changes.
Symptoms
Intense joint pain: Typically in the big toe, but can affect other joints like ankles, knees, elbows, wrists, and fingers.
Lingering discomfort: After the severe pain subsides, some joint discomfort may persist for days to weeks.
Inflammation and redness: The affected joint becomes swollen, tender, and red.
Limited range of motion: Difficulty moving the affected joint.
Causes
Gout occurs when there is too much uric acid in the blood (hyperuricemia). Uric acid is a waste product formed from the breakdown of purines, which are found naturally in the body and in certain foods. Hyperuricemia can be caused by:
The body producing too much uric acid.
The kidneys not eliminating enough uric acid.
A diet high in purines (red meat, organ meats, seafood, sugary drinks and alcohol, especially beer).
Certain medical conditions (kidney disease, diabetes, metabolic syndrome, obesity).
Certain medications (diuretics, aspirin).
Genetics
Medicine Used
Nonsteroidal anti-inflammatory drugs (NSAIDs): For pain and inflammation during acute attacks (e.g., ibuprofen, naproxen, indomethacin).
Colchicine: To reduce pain and inflammation during acute attacks; can also be used in low doses to prevent attacks.
Corticosteroids: Oral or injected, for pain and inflammation when NSAIDs and colchicine are not suitable.
Urate-lowering therapy (ULT): To reduce uric acid levels in the blood and prevent future attacks (e.g., allopurinol, febuxostat, probenecid, pegloticase).
Is Communicable
No, gout is not a communicable disease. It cannot be spread from person to person.
Precautions
Dietary changes: Limit consumption of purine-rich foods (red meat, organ meats, seafood), sugary drinks, and alcohol (especially beer).
Hydration: Drink plenty of water to help flush uric acid from the body.
Maintain a healthy weight: Obesity increases the risk of gout.
Limit alcohol consumption.
Manage other medical conditions: Properly manage conditions like kidney disease, diabetes, and high blood pressure.
Medications: Take medications as prescribed to lower uric acid levels.
Avoid sugary drinks: drinks that are sweetened with fructose
How long does an outbreak last?
An acute gout attack typically lasts for 3 to 10 days. Without treatment, attacks can become more frequent and last longer.
How is it diagnosed?
Joint fluid analysis: A sample of fluid is taken from the affected joint and examined under a microscope to look for uric acid crystals.
Blood test: To measure uric acid levels in the blood. High uric acid levels can indicate gout, but not everyone with high levels develops the condition.
X-rays: To rule out other causes of joint pain and assess joint damage.
Ultrasound: Can detect uric acid crystals in joints.
Dual-energy CT scan (DECT): More sensitive for detecting uric acid crystals.
Timeline of Symptoms
Early stages: Asymptomatic hyperuricemia (high uric acid levels without symptoms).
Acute attack: Sudden onset of severe pain, inflammation, and redness in a joint, typically lasting 3-10 days.
Intercritical period: Period between attacks, with no symptoms. This phase can last for months or years.
Chronic gout: Frequent attacks, leading to chronic joint pain, stiffness, and potential joint damage. Tophi (uric acid crystal deposits) may develop under the skin.
Important Considerations
Gout is a chronic condition that requires ongoing management.
Left untreated, gout can lead to permanent joint damage, kidney problems, and other complications.
Medications to lower uric acid levels are often necessary to prevent future attacks and complications.
Lifestyle changes, such as diet and weight management, can play an important role in managing gout.
Regular monitoring of uric acid levels is important to ensure effective treatment.