Gout – Diagnosis, Symptoms and Risk Factors

Gout is condition that results from crystals of uric acid depositing in tissues of the body and is characterized by an overload of uric acid in the body and recurring attacks of joint inflammation (arthritis). Chronic gout can lead to deposits of hard lumps of uric acid in and around the joints, decreased kidney function, and kidney stones.

Gout is often related to an inherited abnormality in the body’s ability to process uric acid. Uric acid is a breakdown product of purines, that are part of many foods we eat. An abnormality in handling uric acid can cause attacks of painful arthritis (gout attack), kidney stones, and blockage of the kidney filtering tubules with uric acid crystals, leading to kidney failure. On the other hand, some patients may only develop elevated blood uric acid levels (hyperuricemia) without having arthritis or kidney problems. The term “gout” commonly used refers to the painful arthritis attacks.

Gouty arthritis is usually an extremely painful attack with a rapid onset of joint inflammation. The joint inflammation is increased by deposits of uric acid crystals in the joint fluid (synovial fluid) and joint lining (synovial lining). Intense joint inflammation occurs as white blood cells engulf the uric acid crystals and release chemicals of inflammation, causing pain, heat, and redness of the joint tissues.

What are the risk factors?

  • Obesity, especially among the youth
  • Heavy alcohol intake
  • High blood pressure
  • Abnormal kidney function
  • Certain drugs, such as thiazide diuretics, low-dose aspirin, niacin, cyclosporine, tuberculosis medications (pyrazinamide and ethambutol), and others can also cause elevated uric acid levels in the blood and lead to gout.
  • Certain diseases lead to excessive production of uric acid in the body. Examples of these diseases include leukemias,lymphomas, and hemoglobin disorders
  • Abnormally low thyroid hormone levels (hypothyroidism)
  • Conditions such as dehydration, injury to the joint,fever, excessive dining

Symptoms of Gout

  • Small joint at the base of the big toe is where gout attacks quite frequently
  • Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows
  • Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness
  • Tenderness will be so much that even the touch of a blanket can cause discomfort
  • Gout patients will suffer from repeated attacks of athritis
  • Uric acid crystals can deposit in tiny fluid-filled sacs (bursae) around the joints. These urate crystals can incite inflammation in the bursae leading to pain and swelling around the joints, a condition called bursitis
  • In chronic (tophaceous) gout, nodular masses of uric acid crystals (tophi) deposit in different soft tissue areas of the body. Even though they are most commonly found as hard nodules around the fingers, at the tips of the elbows, and around the big toe, tophi nodules can appear anywhere in the body

A firm diagnosis should be made of gout. Other conditions can mimic it. Many cases can be successfully treated. Drugs are available.