Pain syndrome with gout
As already mentioned, attacks most often occur at night. A person wakes up from severe pain in the affected area, which instantly swells and turns red. Sometimes the only symptom of an attack is throbbing pain.
Increased pain lasts 8–12 hours, joint mobility is limited, and the skin temperature in the inflamed area increases. During an acute attack, general health worsens, symptoms such as tachycardia, sweating, and weakness appear. In the absence of drug treatment, gouty arthritis becomes chronic.
Classification of gout
Considering the mechanism of accumulation of uric acid in the body, gout is distinguished between metabolic and mixed types. According to the nature of the manifestation of the pathology, they are classified:
- acute arthritis (an intermittent form in which attacks of the disease are replaced by periods without any symptoms);
- chronic form (periarticular thickenings called tophi are formed, the kidneys are affected).
Asymptomatic disease is detected during laboratory diagnosis in approximately 8–14% of examined middle-aged and elderly men.
Toxic gout caused by lead and molybdenum poisoning is classified into a separate category. These two subcategories of the disease develop in people who come into contact with metals due to their professional activities.
What is gout on men's legs?
Gout, as a rule, has a chronic course, so it is almost impossible to completely cure it. This disease occurs more often on the legs. In men, gout is characterized by the following symptoms:
- Acute pain in the joints, worsening in the morning;
- Redness and swelling of the first finger;
- Stiffness in the limbs;
- Limited mobility;
- Increased blood pressure;
- Increased body temperature;
- Feeling hot;
- Loss of appetite;
- Frequent mood changes.
The first attacks of gouty arthritis (inflammation of one joint) are almost always short-lived. This attack begins suddenly, usually at night. Most often, the joint of the big toe becomes inflamed (maybe one or both).
Photo: gout on a man’s big toe
In addition to the fact that patients experience severe pain, during an attack the joint begins to swell, turn red, the skin in this area becomes bright red or purplish, warm or hot to the touch. Even a slight touch to the inflamed area or minimal movement in the joint causes unbearable pain. After several days of excruciating pain (3-4 days), the symptoms suddenly stop, as if nothing had happened.
However, after a certain amount of time, the pain also suddenly returns. Moreover, if at the beginning the intervals between attacks were quite long (from one month to a year), and the attacks of gouty arthritis themselves were short-lived, then over time the clinical picture changes for the worse. Attacks become longer and the intervals between them shorter.
Eventually, a moment comes when the pain in the joints is constant, and the light intervals between attacks practically disappear. This condition is called “status gouty,” or chronic gouty arthritis. In chronic gouty arthritis, destruction of articular cartilage occurs, and specific defects are formed in nearby bones - “punches”, which are a cavity filled with microcrystals of sodium urate.
In the photo there is a symptom of a “punch” on the bone of the first toe
Sodium urate crystals may also accumulate under the skin, forming whitish, hard nodules (tophi) that are filled with a pasty mass. These tophi often form around the affected joint.
Photo: tophi around the toe joints
In especially advanced situations, gout can cause complications on the kidneys, since urates can also be deposited in them, which leads to urolithiasis and sometimes to pyelonephritis (inflammation of the kidneys).
In men, gout occurs much more often and at an earlier age than in women. The male half of humanity is susceptible to this pathology by the age of 40.
Features of the disease
Gout, or gouty arthritis, develops as a result of the accumulation of uric acid in the body. Often the pathology is considered a disease of the joints, since they suffer first. But this is not entirely true, since the pathology spreads to the entire body.
During normal metabolic processes, uric acid is filtered by the kidneys and excreted naturally. If the biochemical chain is disrupted at any stage, the concentration of acid in the blood increases and hyperuricemia develops. Next, uric acid reacts with calcium or other trace elements, resulting in the formation of microscopic salt crystals (urates). The primary area for urate accumulation is soft tissue in the joints and organs of the excretory system.
Salt crystals, which have a traumatic effect on tissue, provoke the development of an inflammatory process, which is accompanied by severe pain. Settled in the kidneys and bladder, urates form dense rocky formations.
Treatment of gout at the MedCom clinic in Ryazan
The MedCom clinic, equipped with modern medical equipment for diagnosis and therapy, offers a course of effective treatment for gout. Our specialists will develop a personal therapeutic regimen based on the results of the examination.
We guarantee attentive treatment, comfortable procedures, fair prices for services, and long-term maintenance of the achieved results. Sign up for a consultation if you experience the first signs of gouty arthritis. The sooner you start taking a treatment course, the faster your recovery will come.
Treatment
Is it possible to cure gout completely? If the disease is not associated with a genetic factor, it can be completely cured. In case of a hereditary disorder of enzyme synthesis, it is necessary to achieve stable remission, which is achieved by controlling the level of uric acid and eliminating the inflammatory process.
Prevention of pathology and prevention of attacks is based on following a diet, taking anti-inflammatory and painkillers. If you punctually follow the doctor’s instructions, you can count on the high effectiveness of the treatment course. Over time, the amount of urate in tissues decreases, uric acid levels stabilize, and joint mobility is restored.
Diagnostics
The types of diagnostics used to establish a diagnosis depend on the severity of the pathology. After collecting anamnesis (first of all, the doctor must find out whether there are cases of gouty arthritis in the family history), several types of laboratory tests are prescribed:
- general urine analysis;
- general blood analysis;
- examination of synovial fluid;
- blood biochemistry;
- serum urate level determination;
- hardware examination (MRI, ultrasound of kidneys and joints).
During examination, it is important to differentiate gout from rheumatoid arthritis (RA), since the symptoms of the diseases are similar. It is important to know that a small number of patients (approximately 2%) are diagnosed with both diseases at the same time, and their treatment is based on different therapeutic approaches. RA is an autoimmune disease, while gouty arthritis is a consequence of the accumulation of uric acid in tissues.
Medicines
Medicines that lower uric acid levels include colchicine and artrosylene. They are taken systemically to prevent attacks.
- To suppress excessive production of uric acid in the treatment of gout, probenecid, benzbromarone, alopron, adenuric, and allopurinol are prescribed.
- To remove uric acid from the body, the drugs allomaron, allupol and analogues are indicated.
- To stop the inflammatory process, NSAIDs (movalis, diclofenac, ibuprofen, nimesil and others) are prescribed.
The rheumatologist prescribes medications for the treatment of gout, taking into account age, the nature of the development and course of the pathology, the presence of relative contraindications to health conditions and some other factors. Complex treatment includes tablets, injection solutions, topical agents (ointments, gels) in various combinations.
Glucocorticosteroids are rarely prescribed, only if NSAIDs are ineffective and the inflammatory process is eliminated. Hormonal drugs can cause negative side reactions, which limits their use in therapeutic practice.