Patients diagnosed with gout

According to rheumatologists from the National Institute on Aging in the United States, Gout is one of the most painful forms of arthritis . It consists of a group of metabolic disorders in which the crystals of sodium urate (sodium salt of uric acid) are deposited in the tissue. When the levels of uric acid in blood they rise above 8 milligrams per deciliter, the kidney is unable to eliminate it in its entirety and they begin to form crystals of the same (known as tophi) that accumulate and deposit in the joints . It usually occurs on the big toe, but can also affect other joints, including ankles, elbows, knees, wrist, hands and other toes .

 

Symptoms of gout

A gout attack may begin when the uric acid crystals they are formed in the ligaments and / or cavities of a joint. These deposits produce inflammation, redness, heat, pain and stiffness in the joints. Gout attacks usually occur after consuming foods such as seafood, liver, grains, seeds, anchovies (anchovies) or sauces. The consumption of alcohol, being overweight and being taking certain types of medicines could also make gout worse . In older adults, some medications for high blood pressure may also increase the chance of a gout attack. The inflammation could cause the skin to stretch and tighten around the joint, making this area red or purple and at the same time very sensitive. The doctor can suggest blood tests and x-rays, as well as samples of the joint fluid at the moment when an attack is being suffered.

 

Diagnose the drop

The American College of Rheumatology has developed criteria to diagnose gout ; the presence of six suggests the appearance of the disorder. These are:

More of an attack of active arthritis ; maximum inflammation developed over a day.

Attack of oligoarthritis (Joint inflammation that affects more than one joint and less than five).

Redness in the joint.

First articulation metatarsophalangeal (first toe) painful or swollen.

One-sided attack of the first metatarsophalangeal joint.

Unilateral attack of the joint of the tarsus .

Tofo (voluminous deposits of uric acid in joints, tested or suspected).

Hyperuricemia (excess of uric acid in the blood).

Swelling Asymmetric radiography within a joint and complete completion of an attack

 

Who the drop affects

Although it is believed that gout affects only men, it has been shown that some women after menopause You can also suffer it. According to specialists, in men between 18 and 44 years, the number of cases reaches 2 in a thousand, while in men between 45 and 65 years, the number increases to 34 among a thousand.

If the drop is not treated, evolves in four phases :

  1. Asymptomatic hyperuricemia: the crystals need months or years to accumulate, most usually in the peripheral connective tissue and around the synovium of the joints, especially in the lower limbs. During this period there may be no symptoms at all.
  2. Acute attacks: almost always a single peripheral joint is involved in all the initial episodes and the most affected is the metatarsophalangeal joint. Pain is often described as the most horrible experience ever experienced. In 24 hours the inflammation is maximum, and it resolves slowly over a week, often with itching and peeling of the surrounding skin.
  3. Intercrisis drop: These are asymptomatic periods between attacks. Some people never have a second attack, or possibly after many years, but in most the second attack comes in a year
  4. Chronic tophi of gout : they are large glass deposits that produce firm and irregular nodules, predominantly around the upper face of the fingers and hands, but also in other places, including forearms, Achilles tendon or ears. If left untreated, they can produce severe deformities.


Video Medicine: Gout (June 2021).