When To See A Doctor
Gout occurs without warning. Anyone experiencing intense pain on the big toe, followed by warmth, tenderness, redness or discoloration, should immediately seek medical attention.
If a person does not receive treatment for gout, it can lead to joint damage over time, including bone erosions and arthritis.
What Happens At Your Appointment
The GP may ask about your diet and if you drink alcohol.
They may refer you to see a specialist and arrange a blood test and scan. Sometimes a thin needle is used to take a sample of fluid from inside the affected joint, to test it.
The blood test will find out how much of a chemical called uric acid there is in your blood.
Having too much uric acid in your blood can lead to crystals forming around your joints, which causes pain.
Rheumatoid Arthritis Vs Gout
We dont know the exact cause of rheumatoid arthritis, but we know that changes in some of the bodys proteins can set off activation of the immune system, which leads to the release of multiple inflammatory chemicals that cause joint inflammation and damage, with swelling, warmth, tenderness, and discomfort.
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Assessing Signs And Symptoms
The Sharp Pain During A Gout Flare Can Usually Help Distinguish The Two
At first glance, it might seem like gout and rheumatoid arthritis arent so different. Both cause pain, swelling, and stiffness of the joints that can limit your range of motion. However, the cause differs. RA is an autoimmune disease, which means the bodys own immune system attacks the joints, whereas the pain of gout is due to elevated levels of uric acid in the blood. But despite some similarities in symptoms, rheumatologists usually dont have much trouble telling the two conditions apart.
Cases of gout are often clear-cut because the flash of pain patients experience during a flare is so dramatic, says Kelly A. Portnoff, MD, a rheumatologist at The Portland Clinic in Portland, Oregon. It feels like a hot poker in their joint. Whereas if you have RA, the pain kind of creeps up on you.
A patients age also provides clues. While rheumatoid arthritis can affect almost anyone, it most often first appears in women in their reproductive years. Gout tends to arise in one of two life stages: the late twenties/early thirties and the seventies and eighties.
When gout strikes earlier, its often due to lifestyle factors that promote high levels of uric acid, such as meat-heavy diet and excessive alcohol intake, Dr. Portnoff says. When gout appears later in life, its more likely the result of kidney damage or health conditions that increase the risk of gout, such as high blood pressure, diabetes, and heart disease.
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What Causes Gout In The Knee
Gout develops when the body has high levels of uric acid, a normal waste product. This is known as hyperuricemia.
Uric acid is normally excreted through the body via the kidneys, but in some people, levels can remain high and uric acid can start to accumulate and crystallize in various joints. When these uric acid crystals affect the joint in the knee, it can cause gout symptoms in the knee, making the knee joint red, swollen, and hot to the touch. The buildup of uric acid can also impair the knee joints full range of motion, which can make it difficult to walk.
A number of factors can influence your risk for gout.
Signs And Symptoms Of Gout
Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.
Signs and symptoms of gout include:
- severe pain in one or more joints
- the joint feeling hot and very tender
- swelling in and around the affected joint
- red, shiny skin over the affected joint
Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.
Almost everyone with gout will experience further attacks at some point, usually within a year.
Read more about the complications of gout.
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How To Know If You Have Gout
As bacterial infection mimics the clinical features of gout and can be very similar, it is important to rule out any doubt of other medical conditions by examining the fluid from joints for the presence of uric acid crystals. Since gout and infection can co-exist in the same joint, a precise consideration should be made to distinguish between them by sending fluids for culture.
Presence of tophi is used as a diagnostic feature for the presence of gout even if you have not experienced any gout attack either acute or chronic. Tophi can be aspirated and can be visualized under polarized microscopy as well to confirm a diagnosis of chronic tophaceous gout.
Elevated levels of serum uric acid concentrations may be another supportive evidence for the diagnosis of gout, but the presence of hyperuricemia alone doesnt confirm the diagnosis of gout. Similarly, normal uric acid concentrations do not rule out the diagnosis of gout as the level of serum uric acid can be normal during a gout attack too.
Shahid is a pharmacologist with masters in pharmaceutical sciences and pharmacology. In the past, he worked for Maxinov Healthcare Research Division and R.P Biotech. At DiseaseFix, he is a content guide and writer. He is also associated as a researcher with Integrated Resources Pvt Ltd. currently. Shahids areas of interests include cellular and molecular pharmacology, pre-clinical screening, and systemic and clinical Pharmacology.
Rheumatoid Arthritis Vs Gout: Causes And Risk Factors
Rheumatoid arthritis is an autoimmune disease, meaning, the bodys immune system attacks the joints wrongfully, setting off the symptoms associated with rheumatoid arthritis. Inflammation causes the synovium to thicken, which over time destroys the cartilage, allowing bones to rub together.
Risk factors for rheumatoid arthritis include being a female, being over the age of 40, having a family history of RA, smoking, being exposed to environmental pollutants, and being obese.
Gout is a result of crystallized uric acid, which occurs when a person has high levels of uric acid in their blood. Uric acid results from the breakdown of purines found in some foods like red meat and alcohol.
Normally, uric acid passes through our systems and is released through our urine, but with excessively high levels, the uric acid can build up and crystallize in joints and surrounding tissues, causing discomforting symptoms.
Risk factors for gout include eating a diet high in uric acid-promoting purines, being overweight or obese, having an untreated medical condition like hypertension, taking certain medications, having a family history of gout, being male over the age of 40, and recovering from a recent surgery or trauma.
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Effects On Other Treatments
Some drugs interact with allopurinol, so you should discuss any new medication with your doctor before starting it. You should also tell anyone else treating you that youre taking allopurinol.
Do not use complementary treatments, such as herbal remedies, without discussing this first with your doctor or pharmacist. Some of them could react with allopurinol.
You should avoid taking aspirin while youre being treated for gout. If youre in pain, you can take paracetamol and NSAIDs. But remember you should only take one NSAID at a time so do not take another if you have already been prescribed one to reduce the effects of gout attacks.
Allopurinol can also react with drugs that are often prescribed for high blood pressure, such as bendroflumethiazide, indapamide, lisinopril, ramipril.
Allopurinol reduces the breakdown of azathioprine, which is used to treat conditions such as rheumatoid arthritis and lupus. Your doctor may change your dose of azathioprine to account for this.
It can also reduce the breakdown of the leukaemia drug mercaptopurine, so the dose of mercaptopurine will need to be reduced if you take this drug.
Allopurinol may also increase the risk of developing a rash if you take them with the antibiotics ampicillin or amoxicillin.
How Is Gout Diagnosed
Your doctor will do a physical exam and review your symptoms and health history. Tell them if gout runs in your family. Your doctor may detect gout by looking at your joints. To confirm a diagnosis, they will do a blood test or take a sample of fluid from your joint. These can check your uric acid level and look for uric acid crystals.
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Treating Arthritis Of The Knee
The End Of Gout Your Quick Start Plan
Shelly Mannings The End of Gout is not only a fascinating read its also refreshingly practical.
Shelly gives you two simple quick-starts:
Eat more of these
Eat fewer of these
This simple modification can correct years of gout-causing errors in your eating. And you can start on this straight away within a few minutes of getting this program.That really helped my problem of What Is The Difference Between Gout And Cellulitis.
The next step is to follow Shellys 7-day plan.
It tightens up the quick start advice and turns it into a solid, follow-along program.
The 7-day plan was the real clincher for me.
I am a pretty average cook Im competent but not at all skilled or adventurous. Turns out I didnt need to be.
The plan takes away all the thinking and gives me, for the first week, something I can simply copy.
After the first 7 days I used Shellys advice to adapt the plan according to my own tastes.
Which was pretty easy the plan is full of options so you can try different foods and see what you like best.
Its all food you can buy in your supermarket. And it includes lots of nice stuff the chocolate and strawberries desserts were real winners in my house!
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About Tristate Arthritis And Rheumatology
Tristate Arthritis and Rheumatology is first and largest Rheumatology practice in the Northern Kentucky area. Founded by Dr. Arthur Kunath in 1986, our rheumatology practice now consists of six doctors who are board certified in both Internal Medicine and Rheumatology and a Physician Assistant. Patients see one doctor , thereby assuring continuity of care and an individualized doctor-patient atmosphere giving the physician the ability to establish personalized and detailed relationships. Our doctors have received numerous awards, including being listed as Top Doctors in Cincinnati Magazine, receiving the Patients Choice Award, the Most Compassionate Doctor Award, and the American College of Rheumatologys My Doc Rocks award.
Now Its Your Turn To Understand What Is The Difference Between Gout And Cellulitis
Theres today a large number of us who no longer undergo gout because we tackled it at its cause. Of simply trying out the symptoms Alternatively.
Im one of them.
Remember, I got gout for exactly the same factors you own it today.
An unsafe gut microbiome recommended that bacteria that should have been getting rid of another of my bodys uric acid just wasnt.
That bacteria got diminished to the point that my kidneys were trying to deal with the acid on their own.
And they couldnt cope.
Nor can yours.
It wasnt that I was suddenly generating an excessive amount of uric acid. Its that my gut has been no able to help my kidneys remove it from my own body more lengthy.
Plus the transformation from gout to no gout nearly believed as promised.
You can possibly imagine it yourself.. what it would be like to simply never have any gout ever again.
Take my word for it, its wonderful!
No flare-ups, no pain, no being laid-up in bed for days waiting for the pain to subside.
No wanting to know if some potential event will be messed up because Im laid up in agony with another strike.
Just as pleasing is the fact Ive in addition substantially decreased my hazards of troubled diabetes, kidney failure, heart disease and some cancers.
Shellys program lays it all out for us. No special knowledge is required. I found it easy.
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How Can I Manage My Gout And Improve My Quality Of Life
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
For gout in particular:
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
Knowing If You Have Arthritis Of The Knee
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How To Distinguish Gout From Similar Conditions
This article was medically reviewed by Troy A. Miles, MD. Dr. Miles is an Orthopedic Surgeon specializing in Adult Joint Reconstruction in California. He received his MD from the Albert Einstein College of Medicine in 2010, followed by a residency at the Oregon Health & Science University and fellowship at the University of California, Davis. He is a Diplomat of the American Board of Orthopaedic Surgery and is a member of the American Association of Hip and Knee Surgeons, American Orthopaedic Association, American Association of Orthopaedic Surgery, and the North Pacific Orthopaedic Society. This article has been viewed 23,301 times.
Gout can be confused with a number of other conditions, including pseudogout, septic arthritis, rheumatoid arthritis, and osteoarthritis. If you are concerned that you may have gout, your doctor will examine your signs and symptoms. He will also perform diagnostic tests to determine if your condition is in fact gout.