Gout outbreaks usually start on the big toe or lower limb. Gout occurs when high levels of serum urate build up in the body, which can then form needle-shaped crystals in and around the joint. This leads to inflammation and arthritis of the joint. Acute gout attacks are characterized by a rapid onset of pain in the affected joint, followed by heat, swelling, reddish discoloration, and marked tenderness.
The small joint at the base of the big toe is the most common site of an attack. Other joints that may be affected include the ankles, knees, wrists, fingers and elbows. In some people, acute pain is so severe that even a sheet that touches the toe causes severe pain. These painful attacks usually go away in a matter of hours or days, with or without medication.
Rarely, an attack can last for weeks. Most people with gout will experience repeated episodes over the years. The joint most commonly involved in gout is the first metatarsophalangeal joint (the big toe) and is called podagra. Any joint can be involved in a gout attack (and can be more than one) and the most common sites are the feet, ankles, knees and elbows.
They usually feel worse within the first 12 to 24 hours after you realize something is wrong. While most patients will have high levels of uric acid in their blood for many years before having their first gout attack, treatment is currently not recommended during this period due to the absence of clinical signs or symptoms of gout. As you become familiar with the symptoms of gout, you may feel that a gout attack is coming. Maintaining adequate fluid intake helps prevent acute gout attacks and reduces the risk of kidney stones formation in people with gout.
It is important to note that gout and infection can coexist in the same joint (they are not mutually exclusive) and the possibility of sending joint fluid for culture should be considered even in patients with an established history of gout if they are at risk of infection. The big toe is a known site of gout attacks, but gout can affect many different joints throughout the body. Serum uric acid concentrations may support the diagnosis of gout, but the presence of hyperuricemia or normal uric acid concentrations alone do not confirm or rule out the diagnosis of gout, since uric acid levels can often be normal during an acute gout attack. However, the progression of gout is certainly not inevitable, which is close to the best news any patient with gout can hear.
While eating foods that are high in purines can contribute to high levels of uric acid, many experts believe that the role of diet in the development of gout is overemphasized. In a recent study, for example, only 37 percent of people with gout were taking allopurinol, a medication to lower uric acid; among gout patients with frequent outbreaks, only half took it. If you have more than one gout outbreak per year, it's very important that you take a gout medication regularly, says Dr. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks.
Most damage and complications caused by gout can be stopped if you take medications to lower urate levels and have a healthy diet and lifestyle. Over time, gout can start to affect more joints throughout the body and cause problems such as gout, tophus and permanent bone damage. .
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