Gout is an acute type of arthritis that is developed in the peripheral joints in the body. The condition is caused by a high concentration of monosodium urate crystals being deposited in and around the joints and tendons as a result of there being an excess of uric acid in the patient’s body.
The excess of uric acid is usually found to occur in patients who either produce too much uric acid or those whose bodies fail to excrete enough uric acid out of their systems. In a great many cases, gout is a hereditary condition but anybody can suffer from it.
Signs and Symptoms of Gout
Common signs and symptoms of gout include:
- A sudden onset of intense pain in one or more joints
- Swelling in and around the affected joints
- Redness and inflammation in and around the joints
- Difficulty walking
- Difficulty wearing shoes
- Pain when trying to move the joint or at the slightest touch
Gout is most commonly found to affect the big toe but it can actually affect any joint. In almost all cases, patients report that there was no previous pain in the area prior to it suddenly occurring. The sudden onset of pain usually occurs in the middle of the night or upon waking in the morning.
How is Gout Diagnosed?
Gout is usually diagnosed via a range of select criteria, including a review of the patient’s family medical history, a thorough physical examination, and blood tests used to determine the level of uric acid in the body. It is important to note that even if the patient has a high level of uric acid in his blood, this does not automatically confirm a gout diagnosis. The only proven method for making a definitive diagnosis is to aspirate fluid from the affected joint. The fluid is then examined under a specialized polarizing microscope to search for evidence of uric acid crystals. If uric acid crystals are found in the joint fluid, then gout can be confirmed. In most cases, the foot and ankle surgeon may also order x-rays to examine the bones and joints in the foot, ankle, and leg to rule out fractures and other bony pathology.
Although aspirating the joint and examining the fluid is the only definitive way to diagnose gout, most patients can be effectively diagnosed without having to go through the procedure. Usually a review of the patient’s family medical history and the patient’s signs and symptoms are enough to allow a positive diagnosis.
Gout Prevention Tips
If your family medical history places you at high risk for gout, then there are certain things you can do to help reduce your chances of suffering from this painful condition. Gout prevention tips include:
- Avoid eating large quantities of red meat, shellfish, beer, wine, salt, and other foods that are high in purines
- Drink between six and eight glasses of water a day
- Schedule regular examinations by a foot and ankle surgeon
- Try to keep stress, trauma, and infections to a minimum
- Tell your doctor about your family’s history with gout as many medications, such as diuretics, can bring on an acute case of gout
Non-Surgical Treatment Options for Gout
Gout can usually be managed through oral non-steroidal anti-inflammatory medications and with an injection of a cortisone/local anesthetic mixture into the affected area. Ice (if not restricted for a circulatory condition), rest, and elevation of the affected foot can also help reduce the discomfort. Drinking plenty of water is beneficial for decreasing the chance of urate precipitation in the kidney and in cases where the pain is severe, oral narcotic medications may be prescribed for temporary use. Wearing loose-fitting slippers can also help alleviate the symptoms to a degree, at least until the patient can see a foot and ankle surgeon.
When is Surgery Needed?
In severe cases of gout where the medicine is not alleviating the pain or in cases where there is a significant amount of uric acid crystals in the joint fluid, then surgery may be recommended in order to remove the build-up of crystals and to repair the joint.
Regardless of the case, you surgeon at Pennsylvania Foot and Ankle Associates will discuss all of the conservative and surgical treatment options available to you so you can make the most informed decision about your treatment plan.