Gout is a common form of arthritis. It is also a painful condition that usually involving the joints. It is caused by high levels of uric acid in the blood. Uric acid is formed when the body breaks down purines. The purines can be found in the body and certain foods. When symptoms get worse, it is known as flares. When there are no symptoms, it is known as remissions.
There are many risk factors for gout.Gout generally develops in men between age 30 to 45 and women age 55 to 70.
Increased Risk for Developing Gout:
- High Blood Pressure.
- Injury or recent surgery.
- Fasting or overeating.
- Consuming an excessive amount of alcohol regularly.
- Diet high in meat, shellfish, and beverages sweetened with high-fructose corn syrup.
- Taking medications that can increase blood levels of uric acid.
Gout occurs when there is an excess of uric acid in the body. The body makes uric acid when it breaks down purines. Purines are found in the body and the foods we eat. Usually, uric acid crystals can build up in joints, fluids, and tissues within the body when there is an excess of uric acid in the body. Hyperuricemia does not always cause gout. In addition, hyperuricemia without gout symptoms does not need to be treated. The sharp, needle-like crystals cause gout.
- Intense joint pain: can occur at any joint but usually affects the big toe.
- Inflammation and redness: joint is usually swollen, warm, and red.
- Limited movement: not able to move joint normally.
- Lingering discomfort: last from few days to a few weeks.
Symptoms develop quite rapidly. It can last for three to ten days. Usually, the symptoms and signs affect a single joint. Gout attacks are very painful. It can happen quite suddenly, often overnight. The pain is typically severe. So, it shows the severity of inflammation in the joint. The medical term for excessive fluid in a joint is a “joint effusion”.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – reduce swelling and pain. It is used as first-line treatment.
- Colchicine – people who cannot tolerate NSAIDs usually take colchicine.
- Steroids (prednisone) – used in people who cannot take NSAIDs or colchicine. Prednisone is linked with an increased risk of a recurrent gout attack.
Pseudogout also is a form of arthritis that causes sudden joint pain and swelling. It is caused by calcium pyrophosphate dihydrate crystals (CPPD).
The sudden attacks of joint pain, swelling, and warmth can occur when you have pseudogout. It can last for days to weeks. It can affect the ankles, feet, shoulders, elbows, wrists, or hands but it mostly affects the knee.
Besides older age, several other factors also increase the risk for developing pseudogout :
- Joint trauma due to injury or surgery.
- Genetics: some people tend to develop pseudogout and more likely to have symptoms at an earlier age.
- Excess iron: people with a genetic disorder that causes the body to store excess iron.
- Other disorders: some disorders that affect metabolism or endocrine glands are likely to develop pseudogout.
Pseudogout occurs when calcium pyrophosphate crystals form in the synovial fluid in the joints. Crystals can also deposit in the cartilage and can cause damage. The formation of crystal in the joint fluid results in swollen joints and acute pain. Older people have higher possibilities of getting pseudogout compared to younger people. In addition, the genetic condition can cause pseudogout because it always occurs in families.
In addition, other factors may include :
- Low activity of the thyroid gland.
- Parathyroid glands create too much parathyroid hormone.
- Excess iron in the blood.
- High calcium levels in the blood.
- Lack of magnesium.
Pseudogout most often affects the knees. In addition, it also affects the ankles, wrists, and elbows.
General symptoms may include:
- Bouts of joint pain
- Swelling of the affected joint
- Fluid build up around the joint
- Chronic inflammation
Until now, no treatment can completely remove or prevent the formation of calcium pyrophosphate dehydrate crystals. Therefore, treatment is generally focused on reducing pain and swelling.
- Joint injection: insert a needle into the affected joint and take off the fluid. So, the crystals, pressure, and pain will be relieved. Injection of a steroid into the joint can decrease the amount of inflammation present.
- Oral medications such as NSAIDs, prednisone, and colchicine can decrease inflammation and pain.
- Joint immobilization: avoid lifting heavy objects if it involve the legs.