Gout is an inflammatory arthritis that is caused by uric acid crystal deposition in your joint(s) - most commonly the big toe but can also occur in other joints, such as your knees. It leads to an extremely painful, hot, red and swollen joint filled with fluid containing uric acid crystals. Gout accounted for 4.98 million office visits in 2010 and represents 5% of all adult visits for arthritis.1
Crystals accumulate because either your body does not excrete/remove enough or it over produces uric acid. Certain medications, foods and alcohol can contribute to this overproduction or under excretion.
Risk factors for developing gout include obesity, diabetes, high blood pressure, drinking alcohol (beer and liquor) or sugary drinks, and eating red meat and seafood.
Treatment is two-fold:
1. Address the acute gout flair
Aspiration/drainage and sending the fluid for analysis to confirm the presence of crystals. In my office, when indicated, an ultrasound is used to confirm and ensure adequate drainage of the joint fluid.
This is followed by a steroid injection which is an anti-inflammatory that works directly in the affected joint.
At times, I may also recommend using oral anti-inflammatories or Colchicine, but only during the acute flair.
2. Decrease recurrence
Changing your diet which may include eating more whole grains and vegetables. Recommendations are also to eliminate or reduce the amount of meat and seafood you eat. More detailed food recommendations can be found at the Arthritis Foundation
Decrease or eliminate drinking beer, liquor and sugary drinks
Stay physically active and maintain a healthy weight
At times a medication such as Allopurinol may be recommended to help reduce the frequency of acute flairs.
Gout is manageable with lifestyle and dietary changes!
1. The United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2014. Chapter 4. Arthritis.
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