Summary about Disease
Podagra is an older term for gout that specifically refers to gout in the big toe. Gout is a form of inflammatory arthritis caused by hyperuricemia (high uric acid levels in the blood). The excess uric acid forms crystals, which deposit in the joints, causing inflammation and pain.
Symptoms
Sudden, severe pain, typically in the big toe (but can affect other joints).
Swelling, redness, and warmth in the affected joint.
Extreme tenderness to the touch.
Limited range of motion in the affected joint.
Causes
Hyperuricemia: High levels of uric acid in the blood.
Diet: Rich in purines (found in red meat, organ meats, seafood, and alcohol, especially beer).
Genetics: Predisposition can be inherited.
Medical conditions: Kidney disease, diabetes, metabolic syndrome, high blood pressure.
Medications: Diuretics (water pills), aspirin (low dose), some immunosuppressants.
Dehydration: Contributes to uric acid concentration.
Medicine Used
NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Ibuprofen, naproxen. Used to reduce pain and inflammation during an acute attack.
Colchicine: An anti-inflammatory medication that can be used to treat and prevent gout attacks.
Corticosteroids: Prednisone. Can be given orally or injected into the affected joint to reduce inflammation.
Urate-Lowering Medications: Allopurinol, Febuxostat. These medications reduce the production of uric acid.
Uricosurics: Probenecid. These medications help the kidneys remove uric acid from the body.
Is Communicable
No, gout is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
Dietary changes: Limit purine-rich foods (red meat, organ meats, seafood, alcohol, sugary drinks).
Hydration: Drink plenty of water to help flush out uric acid.
Maintain a healthy weight: Obesity increases the risk of gout.
Limit alcohol consumption: Especially beer.
Medication adherence: Take prescribed medications as directed to manage uric acid levels.
Avoid sugary drinks and foods: Fructose can increase uric acid levels.
How long does an outbreak last?
An acute gout attack typically lasts from 3 to 10 days. Without treatment, attacks can become more frequent and last longer.
How is it diagnosed?
Joint Fluid Analysis: A sample of fluid is taken from the affected joint and examined under a microscope to look for uric acid crystals.
Blood Test: To measure uric acid levels in the blood. However, elevated uric acid alone does not confirm gout.
X-rays: Can help rule out other causes of joint pain, but often don't show changes from early gout.
Ultrasound: Can detect uric acid crystals in joints and tophi.
Dual-energy computed tomography (DECT) scan: A specialized imaging test that can detect uric acid crystals.
Timeline of Symptoms
Initial Stage (Hyperuricemia): Elevated uric acid levels may be present for years without any symptoms.
Acute Attack:
Onset: Sudden, often overnight.
Peak: Pain intensifies rapidly within the first 12-24 hours.
Duration: Pain typically lasts 3-10 days with or without treatment.
Intercritical Period: Asymptomatic periods between attacks, which can last for months or years.
Chronic Gout (if untreated):
More frequent and prolonged attacks.
Development of tophi (uric acid crystal deposits under the skin).
Joint damage and deformity.
Important Considerations
Underlying Conditions: Gout is often associated with other health problems like kidney disease, diabetes, and cardiovascular disease. Managing these conditions is important.
Medication Interactions: Be aware of potential interactions between gout medications and other medications.
Long-Term Management: Lowering uric acid levels is crucial for preventing future attacks and long-term joint damage.
Lifestyle Modifications: Diet and lifestyle play a significant role in managing gout.
Tophi: Large deposits of urate crystals can develop, causing chronic pain and joint damage. These may require surgical removal.