Gouty Arthritis
Gouty Arthritis is a metabolic disease marked by acute arthritis and inflammation of the great toe and of the joints.
Etiology
Gouty arthritis is caused by a defect in metabolism that results in an overproduction of uric acid or a reduced ability of the kidney to eliminate uric acid. The exact cause of the metabolic defect is unknown. The condition may also develop in people with diabetes, obesity, sickle cell anemia, and kidney disease, or it may follow drug therapy that interferes with uric acid excretion.
Symptoms
In acute gouty arthritis, symptoms may develop suddenly and usually involve only one or a few joints. They can include:
- Pain that frequently starts during the night and is often described as throbbing, crushing, or excruciating
- Joint appears infected, with signs of warmth, redness, and tenderness
- Joint stiffness
- Fever may be present
- A skin lump which may drain chalky material
Diagnosis
Providing your doctor with complete historical information is very important. Gouty Arthritis can be differentiated from Lupus and Rheumatoid Arthritis through such information. Gouty Arthritis can occur repeatedly in a particular location including the base of the first toe and then commonly in the knees and ankles. Gout usually attacks in one place at a time, whereas other arthritic conditions are more pervasive.
For an accurate diagnosis by a physician:
- A physical examination of the joints can show signs of acute arthritis: swelling, hotness and possibly disfigurement
- Joint aspiration evaluation of the synovial fluid will show uric acid crystals
- Blood tests can show whether uric acid may be elevated
- Joint X-rays may show uric acid crystal deposition and can be used to monitor the disease
Medical Treatment
The goals of treatment are mainly to stop the pain and inflammation associated with the initial attack and to prevent future attacks. One of the most important treatments is staying well hydrated by consuming lots of water. Water helps prevent future acute attacks of gout and also helps prevent uric acid in the kidney from becoming kidney stones. Other treatment options can include:
- Weight loss
- Cessation of alcohol intake
- Medication such as Colchicine, which is effective in reducing pain, swelling, and inflammation with acute gout attacks. The medication works by decreasing the inflammation caused by uric acid crystals within the joint. However, it does not decrease the uric acid levels in the bloodstream. Daily use of Colchicine or Allopurinol helps prevent future attacks.
- Over the counter drugs such as Tylenol or Ibuprofen can manage pain.
Home Treatments
Usually, a normal amount of rest and sleep will help to reduce joint inflammation and fatigue. The painful joints may be wrapped in cotton. They should be elevated and supported on a pad or pillow. In addition,
- Hot fomentations should afford some relief.
- Massage and radiant energy may be employed.
- Plentiful liquids should be administered.
- Some believe that magnetic therapy helps with the pain of arthritis. Although not proven, magnetic current is postulated to re-introduce electrical current to abnormally low energy in the cells and tissues of the body, which some believe to be the cause of the dis-ease.
- Because all arthritis is a form of inflammation, ice packs can be extremely helpful in reducing the pain and swelling of inflammation.
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