The exact circumstances that lead to gout are unknown, but persistently elevated levels of uric acid in the blood may lead to deposition of urate crystals in various parts in the body including the joints leading to gout attacks.
Risk factors for gout include age, ethnicity, dietary factors, alcohol intake, obesity, kidney disease, medications that can increase the uric level in the blood, and genetic factors.
Gout often occurs suddenly and may involve any joint, but classically involves the big toe. The pain is often severe and may be associated with redness, swelling and increased warmth. The pain may subside over the course of a few days and can result in joint damage including during the period in between attacks unless properly treated.
Gout can be diagnosed clinically when a patient presents with typical symptoms associated with an elevated uric acid in the blood. X-rays, Ultrasound and CT scans may also be used to help make the diagnosis. The most definitive diagnosis is made by aspiration of a joint with direct visualization of gout crystals using polarizing microscopy.
Treatment with medications such as nonsteroidal anti-inflammatory drugs(NSAIDs), steroids, or colchicine will help control the initial acute symptoms. Medicines that decrease the uric acid level in the body include allopurinol and febuxostat (uloric). Medications that increase the excretion of uric acid such as probenecid may also be used. Failure of some of the initial therapies or for cases of severe gout, pegloticase (Krystexxa) may be used to rapidly and significantly decrease serum uric acid levels in the blood to dissolve gout crystals in the joints. Eating a low purine diet and maintaining adequate hydration is recommended.
The physicians at GCSP are Board Certified Rheumatologists who are experts in the diagnosis and treatment of gout.
Our approach is to work towards a proper diagnosis and a rapid resolution of acute flare-ups while educating our patients on the best long-term therapeutic options.
Let Us Help You “Get Pain Free, Get Moving, and Get Well” by scheduling an appointment today!