Arthritis gout knee
Gouty arthritis is a metabolic disease marked by uric acid deposits in the joints. The disorder causes painful arthritis, especially in the joints of the feet and legs.
Gout is caused by a defect in metabolism that results in an overproduction of uric acid or a reduced ability of the kidney to eliminate uric acid. The exact cause of the metabolic defect is unknown. The condition may also develop in people with diseases such as diabetes, obesity, sickle cell anemia, and kidney disease, or it may follow drug therapy that interferes with uric acid excretion. Gout occurs in 4 stages: asymptomatic (without symptoms), acute, intercritical, and chronic. In acute gouty arthritis, symptoms develop suddenly and usually involve only one or a few joints. The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating. In other words
very painful! The joint appears infected with signs of warmth, redness, and tenderness. The attacks of painful joints may subside in several days, but may recur at irregular intervals. Subsequent attacks usually have a longer duration. Some people may progress to chronic gouty arthritis, while others may have no further attacks. The risk is greater in men, postmenopausal women, and people who drink alcohol. Symptoms include the following: Joint pain which begins suddenly and affects one or more joints (hip pain, knee pain, ankle pain, foot pain, shoulder pain, elbow pain, wrist pain, hand pain, or pain in other joints). The great toe, knee, or ankle joints are most often affected. Joint swelling and stiffness of the affected joints occur as do warmth and redness. A fever may be present. Skin lumps, called tophi, may drain chalky material. A physical examination of the joints shows acute arthritis. Aspiration of synovial fluid from an inflamed joint is the most definitive diagnostic procedure. Examination of synovial fluid shows uric acid crystals. The uric acid in the blood may be elevated. (It is critical to inspect the joint fluid carefully . Pseudogout, another crystal-induce form of arthritis can mimic gout and the treatment is very different. Pseudogout is due to crystals of calcium pyrophosphate.) Joint X-rays may be normal. The following tests might also be helpful: Uric acid - urine Colchicine is one of the medications that is effective in reducing the pain, swelling, and inflammation associated with acute gout attacks. The pain often subsides within 12 hours of starting treatment, and is completely relieved in 48 hours. The medication works by decreasing the inflammation caused by uric acid crystals within the joint. However, it does not decrease the uric acid levels in the bloodstream. Daily use of colchicine or allopurinol helps prevent future attacks. Non-steroidal anti-inflammatory drugs (NSAIDs) can be very effective in treating the pain and inflammation of an acute gout attack if taken soon after symptoms start. Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain. Codeine or other analgesics may occasionally be prescribed for pain relief. Increased fluid intake prevents the formation of kidney stones. Sometimes, a diet low in purines is prescribed. Organ meats, beer, wine, and certain types of fish contain high levels of purines. Adequate treatment of acute attacks allows people to live a normal life. The acute form of the disease may progress to chronic disease. Since uric acid is normally eliminated by the kidneys, chronic gout may lead to formation of uric acid kidney stones. Complications from gout are related to the following: Side effects of medications
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