Gout usually only occurs in one joint at a time. It is often found on the big toe. Along with the big toe, the joints that are commonly affected are the lower toe, ankle and knee joints. Gout is a type of inflammatory arthritis that causes joint pain and swelling, usually in the form of outbreaks that last a week or two and then resolve.
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. When the body produces too much urate or removes too little urate, urate levels build up in the body.
However, many people with high serum urate levels won't develop gout. Gout is a type of arthritis in which small crystals form in and around the joints. Causes sudden attacks of severe pain and swelling. 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.
The most common site of a gout attack is what is known as the bunion joint on the big toe. It is usually the first joint affected by gout. As gout worsens, the ankle, midfoot, knee, and elbow may become common sites for gout attacks. Uric acid crystals can also build up in soft tissue and form lumps called tofos, usually on the hands, fingers, elbows and ears.
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. Maintaining adequate fluid intake helps prevent acute gout attacks and reduces the risk of kidney stones formation in people with gout. Many people avoid outbreaks of gout and can decrease the severity of their symptoms, and may even stop having gout. Regardless of the location of the gout attacks, the treatment is the same: lower levels of uric acid, so the gout crystals disappear and the tophos dissolve.
Most people with gout will eventually need to have a ULT, so you may want to discuss the advantages and disadvantages of this treatment with your doctor as soon as you have been diagnosed with gout. 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. Gout occurs when urate crystals build up in the joint, causing the inflammation and severe pain of a gout attack. Treatment for gout includes pain relief to help you cope with a gout attack, as well as medications and lifestyle changes to prevent new attacks.
Medications to lower uric acid levels, known as urate reducing therapy (ULT), are generally recommended if you have recurrent attacks of gout or if you have complications from gout. 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. .