Gout is a chronic disease that is accompanied by an increase in the concentration of uric acid in the blood. As a result of its accumulation, urate salts begin to be deposited in the joint area. Subsequently, destruction of the joint tissue and impairment of functional abilities occurs.
Fatty foods, a sedentary lifestyle and alcohol abuse lead to an increase in morbidity among the population. The Yusupov Hospital provides a full course of diagnosis and treatment of gout at any stage of development. Modern equipment, a professional team and high quality services distinguish the clinic from other medical institutions.
According to statistics, men are several times more likely to suffer from gout compared to women. The onset of the disease occurs at 40 years of age. In women, gout is diagnosed closer to 60 years of age. This is explained by a set of certain hormones that help remove excess uric acid from the body. In recent years, doctors have been talking about diseases. Gout can be diagnosed at the age of 20-30 years.
Reasons for the development of the disease
Hyperuricemia is the main cause of gout. This condition occurs in the following cases:
- Obesity. The diet of a gout patient included an excessive amount of fatty foods, simple carbohydrates and high-calorie foods. In addition, eating large amounts of meat increases the risk of developing gout;
- Alcohol abuse;
- History of psoriasis and hypertension;
- Hereditary predisposition.
An increase in the concentration of uric acid occurs as a result of the fact that healthy kidneys are not able to filter its sharply increased amount. Kidney pathology does not allow them to process even normal amounts of uric acid.
Why does eczema occur on fingers?
The exact causes of eczema on the fingers are still unknown. Immunological disorders play a decisive role in its development. The onset of the disease is provoked by external or internal factors, and they may differ from person to person.
What causes eczema on the fingers:
- constant contact with aggressive chemical components or metals;
- dry air, severe frost and other types of thermal effects;
- insufficient hand hygiene;
- frequent mechanical damage, wounds and abrasions on the hands;
- allergic reaction to food;
- hereditary predisposition;
- disorders in the endocrine and digestive system.
Dyshidrotic eczema on the fingers is especially widespread. Its name is explained by the fact that previously the development of the disease was associated with blockage of the sweat glands. The pathology often affects the skin of the palms. Its development is promoted by hyperhidrosis - excessive sweating.
Classification
Depending on the nature of the course of the disease, primary gout is distinguished - an independent disease that occurs against the background of exposure to provoking factors, and a secondary form of the disease, which develops against the background of concomitant pathology. Based on the prevalence of the pathological process, gout is divided into the following types:
- Monoarticular arthritis. Urates accumulate in the area of one joint. Characteristic of the onset of the disease. The most common site of monoarticular arthritis is the big toe joint;
- Polyarticular arthritis. Inflammation affects more than 2 joints. Polyarticular arthritis is characteristic of chronic gout. Localized in the joints of the elbows, wrists, legs, feet and hands.
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Physiotherapy
When pain, inflammation and other disorders subside, you can include therapeutic exercises in your schedule. An expander or a small ball, for example, a tennis ball, will be an excellent assistant for this. The process of gymnastics is extremely easy; it is enough to repeat certain movements several times a day:
- clench/unclench your fist;
- flexion/extension of fingers;
- squeezing an expander or ball.
Regular gymnastics will improve blood circulation, improve nutrition of tissues damaged due to pain, and return joints to their former plasticity and flexibility.
Symptoms in men
At the initial stages of the disease, there are no clinical signs of gout in men. During preventive examinations or examinations for other pathologies, a biochemical blood test detects an increased level of uric acid - hyperuricemia.
The first sign of gout in men that forces you to see a doctor is pain in the joints. Acute gouty arthritis at the initial stage is most often short-term. The attack develops suddenly, mainly at night. The pain syndrome is intense, constant, pronounced. Target joints affected:
- big toe;
- Thumb;
- Knees;
- Elbows;
- Ankle.
The skin over the joint is hyperemic, swollen, and hot to the touch. The joint is limited in movement, since any mobility provokes increased pain. After a few days, the pain goes away, and the patient returns to his usual way of life.
Further progression of the disease leads to a longer exacerbation of gout symptoms in men, and periods of calm are constantly decreasing. Over time, periods of remission are completely absent, and the pain becomes chronic.
In the stage of chronic arthritis, urates are deposited in connective tissue, organs in the form of nodules, which are called tophi. Deposition of urate in the kidneys is the cause of urolithiasis. Sometimes kidney inflammation develops.
Expert opinion
Author:
Elena Yurievna Panasyuk
Rheumatologist, doctor of the highest category, member of the Association of Rheumatologists of Russia
According to WHO data, 5-20% of Russian residents suffer from pathological accumulation of monosodium urate crystals. They are at risk of developing gout. The disease is registered in 0.1% of the population. Similar statistics in Europe and the United States indicate a more deplorable situation.
The number of newly diagnosed cases of gout is growing every year. The main role among the reasons for the early onset of the disease is given to a person’s lifestyle. The prognosis for recovery and quality of life after diagnosis depends on the stage at which the pathology is diagnosed. Severe gout can cause loss of self-care and normal skills. Late access of the population to a doctor is associated with the absence of a specific clinical picture of the disease in the early stages of development.
Doctors at the Yusupov Hospital perform differential diagnostics, which makes it possible to determine the diagnosis. An individual approach to each patient is necessary to select the correct therapy. The doctor’s tasks include relieving symptoms of gout exacerbation and preventing relapses. For this purpose, the Yusupov Hospital prescribes modern drugs that have passed quality and safety control.
Diagnostics
A comprehensive diagnosis of gout includes the following studies:
- Inspection of joints. It is carried out to identify painful areas;
- General and biochemical blood test. They are carried out to identify the inflammatory process in the body. This is evidenced by high concentrations of leukocytes and ESR. Biochemical analysis shows the level of uric acid and creatinine;
- Radiography. Examination of the affected joints determines the development of tophi, as well as the presence of areas with destroyed articular and bone tissue;
- Ultrasound examination of the kidneys. Against the background of severe gout, urate may begin to be deposited in the kidneys. Ultrasound diagnostics allows you to identify pathological foci in organs;
- Examination of synovial fluid. It is necessary to clarify the etiological factor of the resulting inflammation.
Use of physical therapy
The effectiveness of medications is not always sufficient for a comprehensive effect. In this case, experts recommend taking a course of physical procedures that will help restore the functioning of the affected joints and relieve pain.
Magnetic therapy is used quite often because it brings good results. Permitted for use in the absence of severe forms of dermatological pathologies. Therapy is carried out in a special room in a medical institution and lasts from 20 to 40 minutes. For home use, you can purchase a miniature, portable device that has the same good therapeutic effect. The course consists of 10−15 sessions.
Paraffin therapy and mud applications are also done in a medical institution. Special compositions are applied to the affected areas and left for 20-30 minutes. Such treatment is also considered quite effective and can improve the patient’s condition. To achieve results, it may take from 10 to 25 sessions.
Electrophoresis using drugs with an analgesic effect can relieve acute symptoms. As a rule, Novocain or Analgin is used. Special pads soaked in a medicinal solution are applied to the affected area. Non-steroidal anti-inflammatory drugs are often used to ensure lasting results. The course consists of 10-20 procedures of 30 minutes each.
- Treatment of gout with folk remedies, how to treat gouty arthritis on the toes
Differential diagnosis
Quite often, gout is mistaken for other diseases. This is due to the similarity of the clinical picture of the pathologies. Differential diagnosis is carried out between gout and the following diseases:
- Purulent arthritis. Occurs after an infectious disease. Purulent arthritis is characterized by hyperthermia. The diagnosis will be clarified with the help of additional studies;
- Rheumatoid arthritis. It occurs more often in women than in men. The final causes of the development of pathology are not fully understood. Unlike gout, rheumatoid arthritis does not increase the concentration of uric acid;
- Psoriatic arthritis. Occurs against the background of skin manifestations of psoriasis;
- Pyrophosphate arthropathy. It differs from gout by characteristic changes on x-ray and in the analysis of synovial fluid;
- Osteoarthritis. The disease not only has similar symptoms, but can also occur against the background of gout.
Only a doctor can distinguish diseases and make an accurate diagnosis. Self-medication can lead to aggravation of the condition and the development of undesirable consequences.
What is the best way to treat?
Warts can be removed in almost any way. The surgical method, electrocoagulation, laser and cryodestruction, as well as radio wave surgery are used.
Radio wave surgery
, in my opinion, is a more effective method that allows you to remove wart tissue under visual control. When using this method, the tissue is not burned, but is excised along with a small piece of healthy skin. Thus, the likelihood of warts reappearing becomes minimal.
See all photos before and after removal
Histological examination during removal is mandatory if there is the slightest doubt.
Treatment
Doctors at the Yusupov Hospital provide complex therapy for gout. It includes the following components:
- Medications;
- Diet food;
- Lifestyle correction.
Drug therapy for gout at the Yusupov Hospital is carried out using the most effective pharmacological drugs that are registered and approved for use in the Russian Federation. They have a minimal range of side effects. Medicines for gout are prescribed for a long term. The dosage is selected according to the levels of uric acid in the blood.
The objectives of drug therapy are:
- Reduced uric acid levels;
- Reducing the severity of pain and inflammatory syndromes.
The choice of drugs is made by the attending physician on an individual basis. The results of the diagnostics performed are taken into account. For gout, the following medications are prescribed:
- Allopurinol. The action of the drug is aimed at reducing the level of uric acid in the blood. In addition, allopurinol destroys existing urate deposits. It is a sought-after drug for the treatment of gout;
- Febuxostat. Dissolves uric acid salts and reduces the risk of their re-formation;
- Probenecid. Most often used during gout remission. This is due to the lack of effect of the drug on the formation of uric acid;
- Pegloticase. Used in cases of ineffectiveness of other medications;
- Colchicine. The drug prevents the accumulation of uric acid in the body. Due to the large number of side effects, colchicine is used exclusively for the purpose of relieving an acute attack of gout;
- Non-steroidal anti-inflammatory drugs. Reduce the severity of inflammation and have an analgesic effect;
- Glucocorticosteroids. Prescribed to relieve an acute attack of gout. Due to immunosuppression, glucocorticosteroids are used in limited quantities and according to strict indications.
Following a certain diet is an important part of the comprehensive treatment of gout. The daily menu may include:
- Vegetarian soups;
- Limited amount of chicken or duck meat;
- Lenten varieties of fish;
- Fermented milk products (kefir, fermented baked milk, yogurt, cottage cheese);
- Cereals;
- Pasta;
- A sufficient amount of fresh vegetables and fruits;
- Nuts;
- Dried fruits;
- Honey;
- Paste;
- Fruit drinks, compotes, juices;
- Weak tea.
Following a diet is necessary not only during an exacerbation of gout, but throughout life. In this way, it is possible to minimize the number of relapses of the disease.
To reduce uric acid levels, the patient is prescribed medication. Dosages of drugs are selected depending on the indicators. In order to dynamically monitor the effectiveness of treatment, it is necessary to regularly determine the level of uric acid in the blood. A decrease in its concentration indicates positive results of therapy. Control studies are recommended to be carried out every 2-4 weeks, and then once every 6 months. The dose of drugs is gradually reduced until maintenance values are reached. It is extremely rare to completely stop taking medications. Most often this is accompanied by an exacerbation of gout.
After the level of uric acid decreases and the clinical manifestations of the disease disappear, the patient can return to normal life. To prevent recurrent exacerbations, doctors recommend maintaining proper nutrition and leading an active lifestyle.
Types of growths
Currently, there are several types of growths. They differ in the cause that provoked the appearance and clinical signs:
- Heberden's and Bouchard's nodes most often result from arthrosis or severe arthritis with a chronic course. Formed on the phalanges of the index, middle and little fingers. During the period of remission, they hardly bother the patient, but during an exacerbation they have vivid clinical manifestations and significantly worsen his condition. As a rule, they appear in elderly patients and are irreversible changes that cannot be completely cured.
- Hygroma is an elastic small compaction filled with serous or synovial fluid. It often appears on the index finger in the nail area. As a rule, it does not bother the patient. The most likely cause of this disorder is considered to be intense and constant stress on the wrist joints and fingers due to professional activities.
- Lumps formed in high school and university students. They appear on the middle finger and are the result of prolonged and frequent pressure on this area with a pen. They usually disappear when the load is reduced and do not require any special treatment.
Each variety significantly spoils the appearance of the hand and often impairs its functioning. It can appear in one place or affect several joints at the same time.
Forecast
The prognosis for life with diagnosed gout is favorable. Most patients with the disease live to old age. The quality of life improves by following measures to prevent relapses of the disease and undergoing regular examinations by a doctor.
You can get tested for gout at the Yusupov Hospital. The clinic is located in Moscow. The hospital’s equipment makes it possible to accurately determine gout at the initial stages of development. After receiving the research results, experienced doctors develop individual treatment tactics. Modern therapy helps to quickly alleviate the patient's condition. The drugs used meet quality and safety standards. To make an appointment with a rheumatologist, call the contact center of the Yusupov Hospital 24 hours a day, any day of the week.
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External therapy
Ointments and gels may be present in treatment as an auxiliary, but not the main means. The most popular and effective are:
- Bystrum gel;
- Ibuprofen;
- Fastum-gel.
The drugs presented relieve pain, swelling, and improve blood circulation.
Bishofite can have a beneficial effect on buds. Its use involves compresses or baths. This substance is included in many painkillers and restorative formulations.