Gout

What is Gout?

Gout is a subset of Arthritis that is caused by the needle-like crystals of uric acid in your joints, muscles, and/or skin. The crystals form because your body is either overproducing or under-excreting uric acid, which can then group together to form structures that can cause large amounts of pain. Gout typically manifests in 'episodes', which can last from several days to a week. However, there may be as many as several years in between outbreaks in affected persons. 

Facts About Gout

• A little less than 1 out of 100 people in the U.S. have or will have gout at some point. 

Causes

• Overproduction of uric acid
• Certain medications
• Under excretion of uric acid

Risk Factors

• Obesity
• Age
• Thyroid malfunctions
• Exposure to lead
• Certain muscle medications
  • diuretics
  • cyclosporine
  • aspirin
  • levodopa
  • vegetables with purine are fine
  • calf tongue
  • purine - rich diet
  • dairy products appear to be good
  • organ meats increase risk
  • liver meat
• Family history
• Being male
• Drinking large amounts of beer
• Organ transplants

Symptoms

There are several stages of gout, which are marked by different symptoms:

• Asymptomatic tissue deposition
  • Typically no overt symptoms of arthritis, but hyperuricemia is present
    • Gout crystals may have formed, but aren't causing flares
• Acute Flares
  • Can last for days to weeks
• Present with:
  • Pain
  • Swelling
  • Usually in the joint of the big toe
    • Can be many joints in the elderly
• Intercritical Segments:
  • After acute flares, gout can be inactive
    • Without treatment, there will be another flare
  • Interval between flares will decrease over time
  • Hyperuricemia continues
• Chronic Gout:
  • Forms of chronic arthritis
    • sore/aching joints
  • Tophi may form in cooler parts of the body
    • Elbows
    • Finger Joints
    • Knees
    • Outer Ear
    • Toes

Treatments

• Hyperuricemia Medication
• Physical Therapy
• Occupational Therapy
• Splints
• Education
• Weight Loss
• Surgery
• Joint-Assistive Aids

Resources

• The Centers for Disease Control and Prevention has more detailed information and facts on gout.

Sources

• Choi, Hyon K. "The New England Journal of Medicine. Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men - NEJM. New England Journal of Medicine, 11 Mar. 2004. Web. 21 May 2013. 
• Centers for Disease Control