Gout is a type of inflammatory arthritis that occurs in people who have high of uric acid levels in their blood. Needle-like crystal will be formed in a joint due to the acid and cause unexpected severe attack of pain, redness and swelling. It is most commonly seen in men aged more than 75 years old.
Gout will be manifested as hyperuricemia (serum uric acid > 7.8mg/dL) in initial stage. Monosodium urate crystal (MSU) will then deposit in the joints and soft tissues. This may be happened due to excessive uric acid production or kidney cannot excrete uric acid from the body well enough. Inflammation can occur at any tissues in which MSU is deposited.
Stages of Gout
Initially, acute phase which characterized by periodic attacks of synovitis (often self-limiting) followed by chronic phase in which inflammatory and structural changes of the joints and periarticular tissues may result in frequent symptoms. Even though ACUTE gout seldom extends more than 7 days, they often caused numerous functional impairment. In the CHRONIC phase, the frequency of synovitis increase and involves several other joints, being related with persistent join pain, swelling, tophi development and increasing comorbidity.
Acute Gout
Acute gout, also known as gout flare, usually has rapid onset and waking patient from sleep, reaching a peak in 24-48 hours. The pain is terrible and often patient can’t take care of themselves during the flares. The affected joints usually become red, shiny and tender in a few hours after the first appearance of symptoms Most commonly affected joints is the big toe, followed by foot, ankle, knee, wrist, finger and elbow. More than half of the patient who have untreated gout and hyperuricemia develops gouty tophi. Acute gout responsible for the decrease in quality of life among patient. Deposition of uric acid crystal may continue for months or years without causing any symptoms until shedding of crystal into the synovial fluid.
Risk factors of Gout
- Medical condition (Obesity, high blood pressure, high levels of lipid, reduced kidney function)
- Gender (Men usually has a higher risk)
- Diet (excessive consumption of sugary drink and alcohol)
- Family history (First-degree relatives has a higher risk)
- Food (Food high in purine: anchovies, mushrooms, peas, beans, kidney, liver, heart, brain, gravies and others)
Lifestyle advice for people with gout
- Maintain an ideal weight (BMI can be calculated here )
- Consume low fat dairy, soy, vegetables sources of protein and foods rich in vitamin C
- Drink water > 2 liter per day
- Avoid dehydration
- Exercise moderately
- Avoid intense exercise and joint trauma
Vocabulary:
Periarticular tissue: Tissue surrounding a joint
Synovitis: Inflammation of synovial membrane Source
Tophi (plural of tophus): deposits of uric acid crystal Source
Synovial fluid: A fluid acts to reduce the friction of synovial joint during movement Source
For more information, refer here and here
Needle-like crystal will be formed in a joint due to the acid and cause unexpected severe attack of pain, redness and swelling. It is most commonly seen in men aged more than 75 years old.
Great information dear thanks for sharing
That was a well written informative post about an important condition. Most patients that have Gout, also have a metabolic syndrom, as you pointed out this includes Hypertension, Dyslipidemia and Diabetes. So, it is esencial that patients with gout seek for medical attention before their metabolic unbalance exacerbates. I want to thank you, as a member of the medical community, for bringing awareness to people and contributing to a better health. Followed and upvoted.
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