The joints can be so painful that they hurt to move. Sometimes the joints look like they are infected, even though they are not. These bumps are not painful. The diagnosis for gout is made based on a physical examination by your doctor, x-rays, and lab tests. You will be asked about your symptoms and how gout has changed your activities. Because medications and other diseases can cause gout, you will be asked to provide a medical history and a medication list.
Uric acid does not show up on x-rays, but some bone changes can be visible with gout Figure 3. If needed, fluid from the joint can be removed with a needle to confirm the gout diagnosis.
Blood tests may be ordered to check for infection as well to check your uric acid levels. When a painful episode of gout begins, the goal is to decrease swelling, redness, and pain.
New episodes of gout are often treated with non-steroidal anti-inflammatory NSAID medication or a medicine called colchicine. Steroid pills and shots may be used to treat goutas well. Episodes of gout often come and go. After an acute attack, skin overlying the affected joint may peel and shed.
If this occurs on a toe joint, the area may be more likely to develop a fungal infection athlete's foot. Keep the area dry and use an over-the-counter antifungal cream, such as terbinafine or clotrimazole. Patients with a history of gout should consider the following: Avoid foods high in purines such as anchovies, organ meat, red meat, asparagus, mushrooms, spinach, dried beans as well as peas and lentils , and cauliflower.
Limit alcohol consumption to 2 drinks per day if you are a man and 1 drink per day if you are a woman. Consume purine-neutralizing foods such as fresh fruits especially cherries and strawberries , most vegetables, celery juice, and B-complex and C vitamins.
Drink an extra 4—5 glasses of water per day. Maintain a healthy weight. If you suddenly develop a painful, red, hot joint, see a physician as soon as possible. While the diagnosis may be gout, it could also be an infected joint. Treatment should be started immediately.
The goals of treatment of gout are to reduce the pain associated with acute attacks, to prevent future attacks from occurring, and to avoid the formation of tophi and kidney stones. Your physician may recommend one or more of the following treatments for acute attacks: Rest and elevation of the affected joint Anti-inflammatory medications, including ibuprofen, naproxen, or indomethacin Colchicine an oral medication used to reduce inflammation Corticosteroids a type of anti-inflammatory medicine such as triamcinolone injections or prednisone pills For long-term treatment and prevention of recurrent attacks, your physician may recommend one or more of the following: Low-purine diet Colchicine Allopurinol an oral medication used to prevent the formation of uric acid Probenecid an oral medication used to help the body eliminate uric acid In rare cases, surgical intervention may be required in the case of large tophi or to correct any joint deformities.
Barbara Brody. Gout, a type of inflammatory arthritis caused by elevated levels of uric acid, is well known for causing a lot of pain. Gout flare-ups occur when uric acid forms crystals that settle in a joint, often the big toe, where it causes warmth, redness, and excruciating pain.
One highly visible manifestation is gout tophi, or large bumps that form where gout crystals have accumulated. Gout can also affect other joints, such as the knees, ankles, wrists, and elbows.
Over time, gout can become progressive: Flares occur more frequently, affect more joints, and cause underlying damage to your bones. Gout is a highly treatable form of arthritis; medications can help lower levels of uric acid in the body, which prevents flares and long-term damage from gout.
Tophi are rarely an early sign of gout. Tophi are large, visible bumps made of urate crystals. You might find them on your elbow, hands, feet, or the outer edge of your ear. Tophi tend to be easy to spot thanks to their size, but some smaller tophi can only be detected with an MRI or other imaging test.
Tophi look like nodules, bumps, or lumps that protrude from the skin. Tophi often look like swollen, bulbous growths on your joints just under your skin.
Tophi are a symptom of gout , a condition where uric acid crystallizes in joints like those in your feet and hands. Gout can cause episodes of severe pain called gout attacks. Without treatment, gout can become a chronic condition and increase your risk of developing tophi and joint damage.
Gout results from uric acid buildup in your blood. Uric acid normally gets removed from your blood through your renal system in urine, but your diet or certain conditions can make it hard for your body to excrete uric acid.
In this case, uric acid builds up around joints. Some of these locations include:. But swelling can become painful, especially if tophi are actively inflamed. When left untreated, tophi can break down joint tissue, making it harder and more painful to use those joints. This can make your joints look twisted. Tophi can stretch out your skin and make skin uncomfortably tight, sometimes causing painful sores.
When this happens, tophi can break open and release a soft, white material made of hardened uric acid. Large tophi should be removed to prevent any damage to your joint or loss of its range of motion. Your doctor may recommend one of the following surgeries:. Some treatment options for gout that can help reduce your chances of developing tophi include:.
Gout can often be treated by making lifestyle changes , such as losing weight, exercising regularly, and drinking plenty of water at least 64 ounces each day. Consuming certain nutrients found in everyday foods can also help.
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