Diagnosis of gout

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Diagnosis of gout
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Gout is a disorder that results from deposits of sodium urate crystals generating in the joints which leads to attacks of painful joint inflammation. These depostits come from the elevated blood levels of uric acid, a condition called hyperuricemia. Pseudogout can cause symptoms similar to gout, but is caused by a different type of crystal deposits -calcium pyrophosphate!

Incidence of the gout
Gout is more common in men than in women. Usually, gout develops in middle-aged men and after the menopause in women. It is very rare in younger people but is often more severe in people who develop the disorder before the age 30. It is also important to know that gout often runs in families.

Normal cycle of uric acid

What exactly is a uric acid? Normally, uric acid is nothing more then a by-product of cell nucleic acid breakdown. It is present in very small amounts in the blood because the body continually breaks down cells and forms the new ones. Another source of uric acid are the substances called purines which can normally be found in food.

Foods high in purines include:

• anchovies,
• asparagus,
• consommé,
• herring,
• meat gravies and broths,
• mushrooms,
• mussels,
• all organ meats,
• sardines,
• sweetbreads

Possible causes of gout
In most cases, the elevated uric-acid levels are caused by the improper functioning of the kidneys. If for some reason the kidneys cannot eliminate enough uric acid in the urine, too much uric acid in the blood results in urate crystals being formed and deposited in the joints.

There are several other conditions that can cause hyperuricemia. Large amounts of uric acid may be produced because of an inherited enzyme abnormality or a disease such as leukemia, in which cells multiply and break down rapidly.

Sometimes however, the exact cause of gout cannot be determined. Doctors refer to this as secondary gout.

Risk factors for developing gout
There are several possible risk factors that could be linked to developing gout:

• Certain cancers and blood disorders
• Certain drugs - thiazide diuretics, cyclosporine, nicotinic acid, warfarin, salicylates…
• Certain foods, especially those rich in purines
• Hypothyroidism
• Lifestyle factors - consumption of alcohol is a common lifestyle factor that increases the risk of gout.
• Genetics.
• Age and sex.
• Lead poisoning
• Obesity
• Radiation treatment
• Renal failure
• Starvation

Symptoms of gout
• Joint pain

The most common symptom of gout is a sudden joint pain attack. The problem is these attacks can occur without warning. They may be triggered by an:

• injury,
• surgery,
• consumption of large quantities of alcohol or
• consumption of large quantities food rich in purines,
• fatigue,
• emotional stress,
• illness

The pain usually isn’t located in one joint only. Typically, it occurs suddenly and it often happens at night. When you look at the joint that is causing you pain, you should be able to see that it’s becoming inflamed, swells, feels warm, and the skin over the joint appears red or purplish, tight, and shiny.

• Other common symptoms

The other symptoms of an attack can include fever, chills, a general sick feeling, and a rapid heartbeat.

Complications
The big problem is that, after repeated attacks, especially if left untreated, gout can become severe and chronic and may lead to the destruction of tissue and a joint deformity. That’s why the early diagnosis and immediate treatment could be crucial.
What happens if it is left untreated? The joint motion becomes progressively restricted by the damage caused by deposits of urate crystals in the joints and tendons. Not only that, some hard lumps can be seen on joints as a result of crystals depositing. These deposits are called tophi. They can also be seen kidneys and some other organs, under the skin on the ears, in the tough band extending from the calf muscles to the heel (Achilles tendon), or around the elbows.

Diagnosis of gout
• Joint fluid analyze
The doctor usually withdraws fluid from the affected joint to check for crystals of uric acid in patient’s white blood cells.
• Urine test
The patient may have a urine test to measure the amount of uric acid in his or hers excreting.
• Blood test
The doctor may ask the patient to undergo a blood test to measure the uric acid level in patient’s blood.
• X-rays
These tests may show the joint damage and the presence of tophi.

Information provided on this site is intended for informational and educational purposes only. It is not meant to substitute for medical advice provided by your physician or other medical professional. If you have or suspect that you have a medical problem, promptly contact your physician or health care provider. Only your physician can provide relevant diagnosis, prescribe medications and/or put you on adequate therapies.

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