What is Gout?
It is a painful condition of the joint owing to the deposition of monosodium urate crystals. It is the most common cause of inflammatory joint disorders. About 2 to 5% population is afflicted by gout and males are predominant victim of it. There is 5:1 male to female ratio. Symptoms and causes of gout have been elaborated in detail below.
Pathophysiology of Gout
Approximately 90% of the patients of gout are under excretors whereas the others are over producers. Some cases are associated with increased dietary intake of uric acid rich food.
Symptoms of Gout
Most of the patients present with single joint pain. Typically involved joint is metatarsophalangeal joint of big toe whereas knee joint, ankle joint and joints of hands and fingers are involved atypically.
In acute phase, a patient presents with severe joint pain along with swelling, redness, and tenderness of the joint involved. On the other side, chronic patients experience long term symptoms of pain without swelling and tenderness.
Investigations
A physician may advise base line tests along with x-ray of the joints involved. The most definite investigation is joint aspiration that shows monosodium urate crystals in the synovial fluid. A physician may ask following investigations.
- CBC
- Lipid profile: raised cholesterol and LDH
- BSR: increase blood sugar level due to its association with metabolic syndrome
- Uric Acid Level: acute phase may show normal blood uric acid level whereas majority of chronic gout patients show increase uric acid level
- X-Ray: may show erosions and nodules in the affected joints
- Aspiration of joint fluid: synovial fluid show needle like monosodium urate crystals
Management of Gout
The treatment of gout involves acute management and prophylaxis.
Acute Management
Colchicine is a drug of choice for the patients of acute gout. NSAIDs are also used in these patients but with precautions as majority of the patients of gout have cardiovascular and endocrinological disorders such IHD and DM respectively. Steroids are also used in acute management of gout.
Prophylaxis
About 90% of the patients of acute gout don’t experience second attack so in these patients prophylactic measures are not needed. But in the patients who experience more than 2 attacks in a year need prophylaxis. Allopurinol is the drug of choice in prophylaxis of gout. Moreover probenicide etc are also used for this purpose. Life style modification are also recommended.
If symptoms and causes of gout are well-matched with your conditions, than you are open to consult with a physician. To ask free questions post your questions in the query section and to book appointment click the link below.