Gout is caused by an abnormal metabolism of substances called “purines,” a by-product of cell breakdown. They result in the accumulation of uric acid in the bloodstream. When the excretion of the uric acid is disrupted, the accumulation of uric acid in the bloodstream causes crystalline deposits to form in joints or in the soft tissues. Thus, there is sudden and extreme pain with associated swelling, redness, and increased warmth to the affected skin or joint. Classic gout occurs in the big toe joint or in the knee joint. Rarely is it seen in more than one joint at a time. Uric acid accumulation in other joints and areas of soft tissue is less common.
Generally, blood tests are used and the physician must rely on their clinical experience to make the diagnosis. Other areas that gout may present itself are the tops of the foot, the heel, and the ankle joint. In the chronic form of the disease, gout can appear in the joints and tendons. An attack of gout can appear the same as an infection with an elevated temperature present. Some doctors may wish to take a sample from the joint so that it can be analyzed for gout and cultured for bacteria.
Treatment for gout often involves the use of medications for the gout itself, along with those for infections. Corticosteroids may be used to treat the inflammation and can be taken orally or injected into the affected joint. Immobilizing the foot with a removable cast may also be required. Once the proper medication is prescribed the symptoms of gout usually start to subside quickly. Some factors that contribute to the onset of gout are alcohol, red meats, aspirin, and certain medications for high blood pressure and should be avoided. Recurrent gout should be treated with medication to reduce the blood uric acid levels. If you are dealing with gout, contact the office to go over treatment plans with the doctor.