Gout

Gout occurs due to the deposition of uric acid crystals in the joint structures. This rheumatic disease progresses gradually, accompanied by symptoms of arthritis, intense pain, kidney damage and progression of renal failure. For a long time the disease proceeds hidden. But when studying laboratory tests, hyperuricemia, an increase in ESR and a shift in the leukocyte formula to the left can be detected. These signs require a thorough examination.

Main symptoms of gout, treatment and prevention

Gout is a joint disease characterized by metabolic disorders and salt deposition.
The main symptom of gout is an attack of gouty arthritis. The disease is one of the oldest pathologies, described by Hippocrates. At that time it was called the “disease of kings.” Men over 40 years of age are most often susceptible. Signs of gout in women are rarely diagnosed. Provoking factors:

genetic predisposition;
male gender and age over 40;
moderate to severe obesity;
uncontrolled use of medications;
excessive consumption of alcohol and fatty foods.

The main cause of gout is elevated persistent levels of uric acid. As the disease develops, uric acid crystals are deposited in the joints, which leads to their partial or complete destruction.

Etiological factors

The main reason for the progression of gout is metabolic disorder. It is associated with a malfunction in metabolism, leading to the deposition of uric acid, urates and the occurrence of gout-type inflammation.

Experts include predisposing factors:

high content of purines in food (red meat, offal);
alcohol abuse;
disorders of the kidneys, leading to a slow rate of excretion of uric acid;
hereditary predisposition.

Only a specialist can determine the exact causes of gout by analyzing the patient’s lifestyle, diet, and diagnostic results. To make an accurate diagnosis, radiography of the joints is performed, the results of which reveal the symptoms of gouty polyarthritis and characteristic destruction of bone tissue.

Additionally, blood biochemistry and joint puncture are prescribed. When studying joint lubrication, microcrystals of uric acid and urate can be detected. With the long-term development of gout in the kidneys, specialists identify stones of urate origin.

Pain due to gout of the joints - clinical manifestations

Depending on the development of the disease, gout is divided into an asymptomatic stage and acute gouty arthritis. In the first case, the accumulation of uric acid crystals in the joints does not manifest itself in any way. This condition lasts for years and only in 20% of patients can lead to real gout.

Clinical manifestations of acute gouty arthritis:

the presence of swelling in the joint area;
joint redness;
acute pain due to gout of the joints, occurring at night (or morning);
low-grade fever;
deterioration of general condition, apathy, loss of appetite.

In the initial period, pain usually occurs in one joint (big toe or hand), but over time the pathology “invades” neighboring joints. Attacks of acute gouty arthritis can last from several days to several weeks. Without timely diagnosis and qualified treatment, symptoms of the disease begin to appear more and more often. A gradual reduction in the time between attacks is an alarming symptom, signaling the transition of the disease to a chronic form. Your doctor will tell you how to relieve an exacerbation of gout quickly and effectively during a personal consultation.

What is gout?

Gout is the most common inflammatory disease of the joints among all known ; in Russia it affects many hundreds of thousands, and possibly millions of people.
The cause of gout is high levels of uric acid in the blood . This condition is called hyperuricemia , it occurs even more often than the disease - in every fifth or sixth adult.

Clinical picture

The main symptoms of gout are acute, sudden attacks of severe pain and swelling in the joints (arthritis).

In classic cases, suddenly, often at night or early in the morning, a sharp pain develops in one joint; the joints of the lower extremities are most often affected, especially the joints of the first toes.

An attack of arthritis develops acutely (within 12 hours the pain becomes maximum), increasing to unbearable, severe swelling of the affected joint appears, usually accompanied by redness of the skin over it, the joint becomes hot to the touch. Movement in the inflamed joint becomes almost impossible, as does supporting the affected limb. The pain is significant even without movement, often intensifying even by lightly touching the joint. Sometimes gout can cause damage to not one, but several joints at once.

At the onset of the disease, attacks can stop on their own within a few days and respond well to drug therapy. The intensity of the pain is usually so high that the use of medications is necessary. If the duration of the disease is short, then in the period between attacks the pain usually disappears.

If the level of uric acid remains elevated, attacks will be repeated again and again, the intervals between them will shorten, new joints will be involved in the process, and possibly even damage to the spine. Also characteristic is persistent discomfort in the joints during the interictal period. This is chronic gout.

may form
- large deposits of uric acid salts .
It is important that visible – subcutaneous tophi, this is only the tip of the iceberg, tophi can form in bone tissue, destroying it, as well as in internal organs, disrupting their function. There are many risk factors for developing gout. The more risk factors a person is exposed to, the higher the likelihood of developing gout.

There are many reasons for increased uric acid levels:

heredity;
age - the incidence of gout increases with age;
gender - men are more likely to get sick, although in old age the differences between the sexes almost disappear;
obesity;
high blood pressure;
consumption of foods rich in purines (meat and seafood);
taking diuretics;
consumption of alcohol and sugary drinks;
gout often develops with psoriasis, decreased kidney function (regardless of the cause), blood cancer, thyroid diseases and others.

Unfortunately, patients with gout often underestimate their disease and do not always consult a doctor on time, which does not allow timely diagnosis and control of treatment; precious time is wasted and the disease progresses. This is a serious disease; if gout is not treated, the patient may become disabled. In people with gout, the risk of developing diabetes mellitus, kidney complications (urolithiasis, chronic renal failure) and the cardiovascular system (heart attacks, strokes) increases many times compared to those with normal uric acid levels.

The second big problem in the treatment of gout is incomplete compliance by patients with recommendations, which is most often due to insufficient awareness of how to deal with the disease, how to change your lifestyle, when and what medications to take. Often people who are faced with this disease are prone to self-healing and resort to the help of “healers” and “folk” methods, which, at best, do no harm and are always completely useless.

Can gout be cured?

The good news is that gout is completely treatable. A timely diagnosis makes it possible to correctly prescribe treatment, fully control the disease and provide our patients with a high level of quality of life. Attacks can actually be prevented by keeping the level of uric acid in the blood below a certain (target) level. Moreover, with stable maintenance of the target level of uric acid, the risk of developing life-threatening organ damage is reduced significantly.

This is possible even in the most severe cases.

Research Institute of Rheumatology named after V.A. Nasonova is one of the leading medical centers in the Russian Federation, where the treatment of gout has a long history and fully complies with all modern requirements.

Here you can get qualified advice from specialists in the treatment of gout who are directly involved in the diagnosis and treatment of the disease - the laboratory of microcrystalline arthritis.

You will have access to comprehensive information about:

the specific reasons for the development of your disease;
modern diagnostic methods - the diagnosis is made exclusively using the “gold standard” - polarization microscopy;
sonography, radiography and other methods of radiation diagnostics, which virtually eliminates the possibility of error;
modern methods of treatment (selection of therapy is carried out individually, taking into account concomitant diseases, the identification of which is one of the key aspects of treatment);
modern principles of diet therapy, radically different from the canonical ones, and other non-drug methods of treatment and prevention of gout.

Gout is not a death sentence!

Make an appointment with a specialist:

by phone, +7
by filling out the feedback form
receive ]in absentia[/anchor]

Manifestations of gout in men

Gout is a chronic disease that is almost impossible to cure. The disease can develop rapidly or be sluggish. In this case, everything depends on the general condition of the patient and his way of life.

As noted above, gout is diagnosed three times more often in men than in women. The disease affects representatives of the stronger half after 40 years of age. A rheumatologist treats gout in men. After diagnostic measures, collecting anamnesis and examining the patient, the doctor will prescribe a course of drug therapy and monitor its implementation.

On our website Dobrobut.com you can sign up for a consultation and get an answer to the question “gout – what kind of disease and which doctor to see.”

How does a rheumatologist consult for gout?

At the initial stage of admission, the doctor asks the patient about the characteristic manifestations of the disease and finds out the reasons that provoked its development (poor diet, exposure to bad habits, previous surgical operations, kidney problems, long-term course of steroids or antibiotics).

After collecting anamnesis, the doctor conducts an external examination to assess the clinical picture of the disease. Before making a final diagnosis, the rheumatologist refers the patient for additional examinations:

general clinical and biochemical blood test;
synovial fluid analysis;
analysis of tophi contents;
Ultrasound, x-ray, affected joints;
scintigraphy (with the introduction of technetium pyrophosphate).

Treatment of gout

In order for the treatment to bring maximum benefit, it is necessary to change your lifestyle and adhere to a certain diet. High-quality diagnosis and strict adherence to rheumatologist’s prescriptions allows you to take control of the disease and minimize acute attacks. In addition, timely taking medications for gout attacks will help avoid serious complications. The possible consequences of the disease will be discussed in more detail in the next section.

Drug therapy for gout of the thumb is aimed at reducing the level of uric acid in the body and relieving inflammation with acute pain. In the first case, the doctor may prescribe the following drugs: allopurinol, orotic acid, thiopurinol, hepatocatazal or milurite. To solve the second problem, non-steroidal anti-inflammatory drugs are most often prescribed: diclofenac, butadione, indomethacin and naproxen.

Symptoms

Gout often affects the joints of the legs, usually the joint of the big toe. The affected joint turns red and swells, and acute, increasing pain appears in it. In addition, there are a number of associated symptoms:

febrile phenomena,
chills,
general malaise.

If the disease is not treated, the acute phase subsides after a few days, but after some time everything resumes. Pain and swelling with gout arise and disappear spontaneously. Attacks occur more often at night. If left untreated, attacks become more frequent and their duration increases. Arthritis spreads to new, unaffected joints, taking over previously healthy areas and tissues. The appearance of the joint may also undergo deformation changes.

Gout of the thumb: how to prevent an attack

The following recommendations will help prevent attacks of acute gouty arthritis.

Preventive actions:

regular performance of a complex of physical therapy;
daily consumption of at least 2 liters of water;
avoidance of carbonated drinks and powdered juices;
strict adherence to the diet for gout and high uric acid;
strict control over the use of aspirin;
control of uric acid levels in the body;
periodic fixation of the diseased joint in an elevated state;
refusal of fatty and smoked foods.

Your doctor will tell you during your consultation what foods you should not eat if you have gout. We also recommend studying traditional medicine recipes that will help prolong the period of remission.

Risk factors

Among patients who exhibit symptoms of the disease, carriers of certain risk factors are identified. This:

hereditary predisposition,
hypertonic disease,
diabetes,
abuse of bad habits, alcohol,
excessive consumption of unhealthy foods, overeating.

In recent decades, the number of patients suffering from gout has increased. This is due to poor nutrition, the content of foods rich in purines in the diet, and the lack of restriction of bad habits. The disease is often called a “lifestyle disease.”

Gout symptoms and possible complications

Tophi are nodules that form under the skin in the area of the inflamed joint. They can appear in the areas of the fingers, toes, elbows and Achilles tendons. Over time, these nodules begin to eat away at the bone from the inside.

Deformation of the big toe. Without proper treatment, gout can lead to a pathological process in nearby joints (knees, ankles). Read on to learn how to treat gout on the legs at home.

At a severe stage, phlebitis may develop. Urolithiasis is also a common complication of gout.

Who is a rheumatologist?

A specialist in internal medicine, a rheumatologist specializes in the diagnosis and treatment of connective tissue diseases and cardiac pathologies. In other words, his field of vision includes diseases of the joints, kidneys, heart, lungs and skin that are not associated with microbial inflammation. It is responsible for autoimmune processes.

Modern medicine includes about 200 diseases, the study, prevention and treatment of which is carried out by a rheumatologist. Conventionally, they are combined into 6 large groups:

cardiac pathologies;
systemic connective tissue diseases;
vasculitis;
diseases of the joints of the upper and lower extremities;
diseases of the axial skeleton;
background disorders of the immune system.

The rheumatologist's competence includes serious health problems, often of a chronic, recurrent nature and disturbing the patient for a long period of time.

How to treat gout at home

The main treatment for the disease is drug therapy and diet. Traditional medicine, physical therapy and physiotherapy are auxiliary methods prescribed, as a rule, during the period of remission.

Taking into account the causes of gout on the hands and the results of laboratory tests, the doctor will prescribe a medicinal course of treatment with the mandatory use of auxiliary therapy.

If you have any questions and need personal advice from a specialist, please contact our clinic. Consultations are conducted by doctors with many years of experience. You can make an appointment on the website and at the above numbers.

Related services: Orthopedics and traumatology Heel spur symptoms

How to prepare for the initial examination by a doctor?

Typically, the rheumatologist refers the patient to undergo laboratory tests, so 2 days before his visit it is necessary to give up alcohol and smoking. You must come to your appointment on an empty stomach, and you are also prohibited from drinking tea, coffee, or sweet drinks.

A consultation with a specialist will be much more productive if the patient makes a list of questions that interest him in advance (about treatment options, side effects of prescribed medications, the need for lifestyle changes, etc.).

The doctor should be shown a list of medications you are taking (including over-the-counter medications, vitamins, and herbal supplements).

For the examination, it is recommended to choose comfortable clothing that is easy to remove. Don't forget about personal hygiene: take a shower in the morning and put on clean underwear.

Diagnosis and treatment

During the appointment, the endocrinologist will listen and examine the patient and palpate the thyroid gland. If necessary, he will prescribe laboratory tests and refer you for an ultrasound examination, which you can undergo without leaving the clinic. This will allow the disease to be detected even at an early stage.

In some cases, an endocrinologist in Veliky Novgorod goes to the patient’s home.

Special tests that can be taken at the VIVOclinic medical center:

a blood test to determine the level of the main hormones of the thyroid and parathyroid glands, in particular vasopressin (diagnosis of diabetes insipidus);
on the content of vitamin D, which affects the activity of the immune system and metabolism;
level of protein, cholesterol, triglycerides, glucose;
concentration of sugar, AST and ALT enzymes in the blood;
a general urinalysis, which reflects your metabolism and overall health status.

Based on the results of the examination, laboratory and instrumental studies, the endocrinologist will draw up an individual treatment plan for the patient, including hormonal therapy and nutritional recommendations. In acute cases, he will recommend surgery.