Health & Medical Rheumatoid Arthritis

What Causes Gout and How Is It Diagnosed?

If you've ever had to deal with big toe gout or a gout attack of any type, chances are your uric acid levels are too high.
On the other hand, not everyone who has high uric acid levels will go on to have a gout attack.
In fact only one in five people with an elevated uric acid level will have to deal with the pain and inconvenience of a gout attack during their lifetime.
This may be somewhat reassuring, unless you happen to be that one in five! In that case, gout can become a lifelong problem that keeps coming back again and again.
Fortunately, lifestyle changes and diet can reduce the risk of it returning and doing long-term damage to your joints.
High Uric Acid Levels Are a Problem With Gout People who have gout have high uric acid levels, either because they produce too much uric acid, or because their kidneys don't excrete enough of it.
Uric acid is a product of the breakdown of compounds called purines that are found in food and also produced by the body.
When there's too much uric acid, it builds up in the bloodstream.
At some point, levels can become so high that uric acid crystals form and deposit in the synovial fluid, the liquid that lubricates the joints.
This causes white blood cells to come into the picture to destroy these crystals that they see as foreign bodies.
When they do, they release chemicals that cause inflammation and pain.
So, the pain of gout comes from the immune system's response to uric acid crystals in the synovial fluid that bathes the joints.
Big Toe Gout is the Most Common Type Gout can affect any joint, so why the emphasis on big toe gout? Gout most commonly afflicts its cruel and unusual form of pain on the second joint from the tip of the big toe called the metatarsalphalangeal joint.
How does a typical attack of big toe gout present? An attack of big toe gout or podagra commonly occurs in the middle of the night and may awaken its unfortunate victim from their sleep.
The characteristic pain, redness and swelling of the big toe are so characteristic that most doctors have no problem identifying the cause, but it can be more challenging to diagnose gout that affects other joints.
When a gout attack affects a joint other than the big toe, the diagnosis may not be so clear-cut.
The redness, swelling and pain a person suffering from gout gets can look very much like an infection in the synovial fluid that lubricates the joints called septic arthritis.
It's important to make the distinction since septic arthritis is a serious condition that requires immediate treatment.
Gout can also mimic other conditions such as rheumatoid arthritis, autoimmune diseases and a condition known as pseudogout.
That's why many doctors sometimes have difficulty making the diagnosis.
Even uric acid levels aren't very helpful since they may not be elevated during a gout flare.
That's why some doctors place a needle into the joint and get a sample of the synovial fluid to send to the laboratory.
(Don't worry.
They numb you up first).
In the laboratory, a technician will look at the sample under the microscope to see if uric acid crystals are present - to clinch the diagnosis.
It's always a good idea to make sure you're treating the right condition! The Bottom Line? Gout is a painful disease that can sometimes masquerade as other conditions.
That's why it's important to see a doctor and get a proper diagnosis.
Don't try to diagnosis it yourself.

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