Acute Gouty Arthritis

Definition

Definition of Acute Gouty Arthritis
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis-a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected (approximately 50% of cases). However, it may also present as tophi, kidney stones, or urate nephropathy. It is caused by elevated levels of uric acid in the blood which crystallizes and the crystals are deposited in joints, tendons, and surrounding tissues.

Symptoms

Symptoms of Acute Gouty Arthritis

1. Symptoms usually involve only one or a few joints. The big toe, knee, or ankle joints are most often affected.
2. The pain starts suddenly, often during the night and is often described as throbbing, crushing, or excruciating.
3. The joint appears warm and red. It is usually very tender (it hurts to lay a sheet or blanket over it).
4. There may be a fever.
5. The attack may go away in a few days, but may return from time to time. Additional attacks often last longer.

Causes

Causes of Acute Gouty Arthritis
Gout is caused by having higher-than-normal levels of uric acid in your body. This may occur if:

1. Your body makes too much uric acid
2. Your body has a hard time getting rid of uric acid

Diagnosis

Diagnosis of Acute Gouty Arthritis
Tests that may be done include:

1. Synovial fluid analysis (shows uric acid crystals)
2. Uric acid - blood
3. Joint x-rays (may be normal)
4. Synovial biopsy
5. Uric acid - urine

Prognosis

Prognosis of Acute Gouty Arthritis
Proper treatment of acute attacks allows people to live a normal life. However, the acute form of the disease may progress to chronic gout.

Treatment

Treatment of Acute Gouty Arthritis
Medicines should be taken as soon as possible if you have a sudden gout attack.

1. Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin as soon as your symptoms begin. Talk to your health care provider about the correct dose. You will need stronger doses for a few days.
2. Your health care provider may prescribe strong painkillers such as codeine, hydrocodone, and oxycodone.
3. A prescription medicine called colchicine helps reduce pain, swelling, and inflammation.
4. Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
5. The pain often goes away within 12 hours of starting treatment, and is completely relieved in 48 hours.

Prevention

Prevention of Acute Gouty Arthritis
The disorder itself may not be preventable, but you may be able to avoid things that trigger your symptoms. Limit alcohol consumption and follow a low-purine diet.