About the disease

Gout is an inflammatory form of arthritis, manifested by pain and swelling of the big toe. Other leg joints may also be affected, but most commonly the big toe is the place where the burning pain radiates from. Gout can be a recurrent condition and without effective treatment it can affect other tendons and soft tissue.

According to WebMD, the most common cause of gout is the build-up of uric acid in the blood. If there are abnormally high levels of uric acid in the blood, hard crystals can form the in joints, which can lead to the onset of arthritis. Most commonly, this type of arthritis manifests itself as acute pain and stiffness. Gout is more common among men than women.

Gout can be caused by the excessive consumption of certain foods and drinks. Over indulgence in alcohol, eating foods that contain the chemical purine (such as fish and red meat) and being generally overweight can all lead to the development of gout. Certain diuretics can lead to the development of gout as they are designed to increase the amount of water and salt expelled from the body as urine, thereby enabling crystals to form in the body.

It might be weeks or even months before the symptoms of gout manifest themselves for the first time. As gout progresses, the radiating pain in the big toe becomes more and more severe. It is important to seek out treatment as soon as possible, to prevent the progression of arthritis.

Symptoms

• Sharp pain in the big toe
• Swelling
• Redness
• Tenderness
• Skin is red around the affected joint
• Pain is usually more acute at night

Diagnosis

• During a general examination, the doctor will check the patient’s toes for signs of swelling and tenderness, which are common arthritis symptoms. The doctor will also ask the patient to move the affected toe and to stand up, to find out how strong the pain is and where it radiates to.
• A blood test will be performed to measure the amount of uric acid in the blood.
• A sample of fluid from the affected joint is the most reliable test for diagnosing gout. If the sample shows a high level of uric acid, this is likely to have provoked the inflammation.

Treatment

• Conservative treatment is usually sufficient to get rid of gout. Doctors often use corticosteroids to reduce the pain and alleviate the swelling. It usually takes less than 24 hours for these medicines to take effect and they rarely need to be taken for a continuous period of time.
• Once the inflammation has subsided (which can take a few days) the patient may also be prescribed further medicines that prevent the build-up of uric acid crystals in the joints, to prevent a recurrence of gout.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko