Gout is a disease created by a buildup of uric acid. In this condition, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons and surrounding tissues due to elevated concentrations of uric acid in the blood stream. This provokes an inflammatory reaction of these tissues.
Signs and Symptoms
Gout is characterized by excruciating, sudden, unexpected, burning pain, as well as welling, redness, warmth, and stiffness in the affected joint. This occurs commonly in men in their toes but can appear in other parts of the body and affects women as well. Low-grade fever may also be present. The patient usually suffers from two sources of pain. The crystals inside the joint cause intense pain whenever the affected area is moved. The inflammation of the tissues around the joint also cause the skin to be swollen, tender and sore if it is even slightly touched. For example, a blanket or even the lightest sheet draping over the affected area could cause extreme pain. Gout usually attacks the big toe; however it also can affect other joints such as the ankle, heel, instep, knee, wrist, elbow, fingers, and spine.
The first line of treatment should be pain relief. Once the diagnosis has been confirmed, the drugs of choice and indomethacin, or other anti-inflammatory drugs and corticoid injection. Colchicine was previously the drug of choice in acute attacks of gout, as it impairs the mobility of granulocytes and can prevent the inflammatory phenomena that initiate an attack. Colchicine should be taken within the first 12 hours of the attack and usually relieves the pain within 48 hours, although the side effects of nausea and diarrhea can complicate its use. NSAIDs are the preferred form of analgesia for patients with gout.