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GOUT

It is an acute inflammatory arthritis (inflammation of joints). Gout is characterized by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe. Gout is caused by monosodium urate monohydrate crystals and  pseudogout is caused by calcium pyrophosphate crystals

Symptoms

Intense joint pain: Gout usually affects the large joint as big toe, but it can occur in your feet, ankles, knees, hands and wrists. The pain is likely to be most severe within the first four to 12 hours after it begins.

Inflammation and redness: The affected joint or joints become swollen, tender, warm and red.

Limited range of motion: Decreased joint mobility may occur as gout progresses.

Fever may be present (infectious arthritis).

Eye involvement – Tophi, crystal-containing conjunctival nodules, band keratopathy, blurred vision, anterior uveitis (rare), scleritis

Diagnosis

  • Joint aspiration and synovial fluid analysis
  • Serum uric acid measurement (though hyperuricemia is not diagnostic of gout)
  • 24-hour urinary uric acid evaluation
  • Blood studies (including white blood cells [WBCs, triglyceride, high-density lipoprotein, glucose, and renal and liver function tests) 

Preventions

Both lifestyle changes and medications can decrease uric acid levels. Dietary and lifestyle choices that are effective include reducing intake of food such as meat and seafood, consuming adequate vitamin C, limiting alcohol and fructose consumption, and avoiding obesity. Drugs used are NSAIDS, Colchicine, steroids, probenecid,  sulfinpyrazone etc

 

Complications

  • Severe degenerative arthritis
  • Secondary infections
  • Urate or uric acid nephropathy
  • Increased susceptibility to infection
  • Urate nephropathy
  • Renal stones
  • Nerve or spinal cord impingement
  • Fractures in joints with tophaceous gout