Gout - signs of
Gout is a disease in which, due to metabolic disorders in various tissues of the body, urates( uric acid salts) begin to accumulate, causing inflammatory processes there. The kidneys and joints suffer the most( the thumb of the foot is more often affected).In the early stages, the disease is easier to treat, so it is so important to know the first signs of gout.
How to recognize gout?
There are four stages of the disease, which are characterized by various pathological processes. Consider the main signs of gout in women at each stage.
As a result of accelerated formation in the body of uric acid, its content in the blood rises. This can be caused by the participation of purine in metabolism, impaired renal function or increased fructose in food. There are no clinical manifestations of the disease at this stage.
Acute gouty arthritis
The first clinical sign of gout disease is an attack of arthritis( more often on the legs).It develops usually after persistent and long-term hyperuricemia. Preceding an attack within 1 to 2 days may be as follows:
- general malaise;
As a rule, the metatarsophalangeal joint of the first toe is affected, more rarely - the knee, ankle or foot pile. There is a sharp, sudden pain in the joint, which quickly grows and becomes intolerable. The attack in most cases occurs at night or early morning. The following symptoms can also be observed:
- swelling in the area of the affected joint;
- limitation of mobility in the joint;
- reddening of the skin in the affected area( followed by desquamation);
- increased body temperature;
- increased sweating;
- increase in blood pressure.
These symptoms completely regress within a few days or weeks.
After the first joint attack( attack), there is often a long period of "full well-being" - from several months to several years. The joint functions are completely restored, and the sick person can feel absolutely healthy.
In the future, acute attacks are repeated at different intervals, capturing an increasing number of joints of the lower and upper extremities. Over time, the interictal periods become shorter.
Chronic arthritic deposits in the joints
This stage is characterized by the formation of gouty joint changes and kidney damage. There are two forms of kidney damage:
- Urinary nephropathy - characterized by a non-permanent presence in the urine of protein, leukocytes, as well as hypertension.
- The formation of urate stones as a result of massive precipitation of uric acid in the tubular system of the kidneys and ureters;this can cause acute renal failure.
Joint deformation occurs as a result of destruction of cartilage and articular surfaces, as well as infiltration of periarticular tissues with urate.There is the formation of tofusi - seals from clusters of urate crystals, surrounded by inflammatory cells and fibrous masses. As a rule, tofus are localized on the auricles, over the affected joints, skin over the Achilles and popliteal tendons.
Radiological signs of gout disease
Reliable X-ray signs of the disease can be observed no earlier than five years after the onset of the disease. This method is not used for early diagnosis, but only for monitoring the effect of chronic gout on joints.
GoutGout is one of the common types of arthritis( inflammation of the joints) and occurs more often in men( mostly middle-aged).Gout occurs more often in men( mostly middle-aged) than in women.
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The onset of the disease is closely related to the amount of uric acid that occurs as a result of processing certain foods rich in purines in the body.Related newsThe common cherry saves from pain in the legs
Normally uric acid is excreted by the kidneys with urine. However, in patients with gout uric acid or too much is formed, or it is poorly excreted by the kidneys, as a result, the body accumulates its surplus. When uric acid is too much in the body, it begins to be deposited in the joints in the form of tiny crystals, which leads to inflammation and pain. It should be borne in mind that there is no clear relationship between the level of uric acid in the blood and the development of gout - in some cases, attacks gout develop in people who have uric acid levels within normal limits.
An increase in the level of uric acid in the body can be associated with impaired renal function, as well as the intake of certain medications.
Symptoms of gout
There is acute pain, swelling and redness of the joint( usually one or two).This acute condition( it is often referred to as by the attack of gout ) can last for several days or weeks( if no treatment is given). The attack of gout often occurs at night, the joint becomes hot to the touch and is very sensitive even to light touches.
Very often the joints of the thumb on the foot are affected, but other joints( ankle, knee, fingers and hands) may be involved. In some cases, joint tendons become inflamed at the same time.
If attacks gout occur frequently and for a long time, it can lead to serious damage to the joints and to limiting their mobility. In some cases, white nodules( tophi) are noted under the skin of the joints or around the auricle, which are a cluster of uric acid crystals.
What you can do
You should consult a doctor to make a diagnosis. The sooner you go to the doctor, the sooner the treatment will begin. With properly selected therapy, exacerbation of gout occurs after 1-2 days. If you really have gout, then, in addition to meeting all the prescriptions of a doctor, you should follow a very strict diet.
You should not eat( especially during an exacerbation) all products rich in purines: meat by-products( heart, kidneys, liver, brains, etc.), fatty fish( especially during the exacerbation period), salted and fried fish, canned foodmeat and fish), sharp and salty cheeses, red meat and products from it, lard, soups on meat, chicken, fish, mushroom broth;smoked meat products, beans( lentils, peas, beans, beans, soybeans).
You should not drink alcohol that increases the uric acid content and worsen its excretion by the kidneys( beer, cognac drinks, fizzy and dessert wines).
It is recommended to drink plenty of water, green tea.
When attacks gout it is necessary to provide sufficient rest for the affected joints and try to injure the joint as little as possible with clothing or shoes.
Keep track of your weight. However, any program for weight loss should be carried out under the supervision of a doctor, tk. A sharp weight loss can lead to an exacerbation of gout.
Be sure to tell your doctor about all medications that you are taking.
What the doctor can do
The doctor should make a diagnosis by conducting various additional studies( including a blood test and determining the level of uric acid).With prolonged gout, an X-ray examination of the joints may be required.
The doctor will prescribe drug therapy during the period of exacerbation, will give recommendations on the diet and the regime of physical activity and motor activity.
Based on the results of the additional studies, the doctor will select a treatment aimed at reducing the level of uric acid in the blood. Keep in mind that drugs prescribed during the period of exacerbation are not intended for long-term use and, as a rule, do not affect the level of uric acid.
Prevention of gout
If there are cases of gout in your family, then you are at risk. In this case, it is recommended to monitor the level of uric acid in the blood regularly, and also try to stick to a healthy lifestyle. Gout often occurs in individuals with high body weight and high blood pressure. Proper nutrition with the restriction of meat and other purine-rich foods plays a crucial role in the prevention of gout.
The first signs of gout: how to identify the insidious disease
Manifestations of gout - a visual aid
What is this disease - gout?
Gout is a disease that occurs due to a violation of the metabolism of purine bases in the body. This disease has been known since ancient times. Gouty attacks are described in the writings of Hippocrates and his followers.
Gout is called "the disease of kings", its descriptions are found in classical literature and drama. This name and popularity of this disease are associated with its occurrence due to a violation in the diet - the abuse of meat fatty dishes - and the widespread prevalence in old age.
In the last century after the disease of gout, people became disabled, and malnutrition caused frequent exacerbations. Know how gout is manifested, it is necessary for everyone, because its first signs are easily not noticed, and then treatment of the disease will be much more difficult.
Gout is a disease that occurs due to metabolic disorders in the body, when the production and elimination of purines, components of uric acid, is disrupted and they begin to accumulate in the body. This can be caused by genetic disorders in the enzyme system or an increased content of uric acid in food. Also, the cause of gout can be abnormalities in the work of the kidneys.
Hand fingers suffering from gout
Symptoms of the disease appear with the deposition of urate salts - urate, which in their structure, resemble a needle and, deposited in the joints and kidneys, cause severe pain.
Causes of the disease
Today, doctors using modern medicines facilitate the patient's condition and suspend the course of the disease. But, nevertheless, it often affects older men. Women suffer from this disease much less often, and its onset often coincides with hormonal changes in the body - menopause. Predisposition to the disease is transmitted genetically, so that it can be considered a hereditary pathology.
The course of the disease is recurrent, chronic, complete cure of the patient is impossible. All methods of treatment are aimed at stopping the pathological process and preventing recurrence of the disease.
The main causes of the disease include the following:
- Genetically determined enzyme deficiency, leading to disruption of metabolic processes.
- Metabolic disorders.
- Diseases of the kidneys and urinary system - disrupted the release of products of disintegration of uric acid.
Risk factors that trigger the onset of the disease:
- violation of diet - eating large amounts of animal protein;
- regular use of alcoholic beverages.
What happens in the body during an illness?
The appearance of gout is associated with an increase in the content of uric acid in the body. Excess uric acid occurs when there is a violation of its secretion or increased education in the body. Not excreted in time from the body uric acid, which includes salts - urate, is deposited in the form of crystals. They cause inflammation in the joints and kidneys.
Salts form crystals, in their structure resembling needles. When they are absorbed by protective blood cells - neutrophils, they cause their destruction and the reciprocal inflammatory response of the body.
This inflammation causes severe pain and with its progression, gouty nodules are formed - salt deposits. Such deposits usually appear on the auricles, small joints of the hand and foot. Without proper treatment, these formations can completely disfigure the appearance of the joint.
Gout: symptoms and treatment, photos, signs of goutThe ancient Greeks called gout "trap for the feet."From the end of the XVII century gout is considered a separate disease. Gout was mostly male, but now it has overtaken the female half of humanity, and arises in the joints of the hands and feet. It was a consequence of the fact that people often overeat and abuse alcohol, in the treatment of diseases, many medications, diuretics( diuretics) are used. Since the withdrawal of uric acid from the body is delayed, it crystallizes and is deposited in the joints, turning into a sodium salt - sodium monourate. Modern physicians consider gout to be a systemic disease that affects the body completely. Signs and treatment of this disease, the first symptoms of gout you will learn from our article.
Causes of goutThe disease is divided into two groups, depending on the cause of the onset.
- 1) Primary gout in the vast majority of cases occurs as a consequence of the violation of hormonal and genetic factors, to which improper nutrition and the use of alcoholic beverages are added.
- 2) The secondary form is a consequence of metabolic disorders, as well as excessive intake of medications. To such medicines carry: Pyrazinamide, Aspirin, Nicotinic acid and various diuretics.
- the genetic predisposition of
- men have a higher chance of getting sick, unlike women.
- as a rule, the disease is diagnosed up to 40 years.
- taking medications, especially diuretics
- , alcohol abuse increases the risk of gout, especially for beer.
- excess weight also contributes to hyperuricemia.
- metabolic disorders, obesity;
- consumes high-calorie meat, fish food in fried form, abuse of vegetable and animal fats and alcohol;
- hypothermia or overheating of joints and a great physical load on them;
- heredity factor.
Signs and symptoms of goutThe first phase of gout proceeds without symptoms, the level of urates gradually increases in the body, which in the future can lead to gout. This stage lasts a very long time, up to 25 years or more. The second phase is acute gouty arthritis. The first symptoms of gout in this stage are manifested by pain and swelling near the affected joint, as well as a rise in body temperature. The clinical picture of gout has pronounced signs:
- usually exacerbation begins early in the morning, or late at night;
- there is a sharp pain in the joint affected by acid-uric crystals, usually a thumb on the leg;
- there is redness and shine of the skin, together with swelling in the joint and periarticular tissues;
- the temperature rises, touching the joint is very painful;
- general weakness and malaise of the body is also present.
Diagnosis of goutFor diagnosis, the frequency of recurring seizures is considered. The diagnosis is made on the basis of:
- 1) Urate monosodium crystals found in the synovial fluid and the absence of microorganisms in it;
- 2) Confirmed tofus through chemical research or polarization microscopy;
- 3) 6-12 signs of gout: X-ray, laboratory, clinical;
- 4) Hyperuricemia, asymmetric inflammation of the joints;
- 5) On the roentgenogram - subcortical cysts without erosion.
Treatment of goutTreatment of gout is reduced to relief of acute attacks, drug treatment, diet and prevention of repeated exacerbations. Coping with an acute attack:
- prescribe a copious alkaline drink 2-2.5 liters / day.) And complete rest;
- apply compresses, applying Dimexide in solution - 50% for analgesia and against inflammation;
- arrest an attack with non-steroidal anti-inflammatory drugs: Indomethacin, sodium diclofenac, Naproxen, Pyroxicam;
- relieve pain and inflammation of Nimesil and Colchicine;
Treatment of gout between attacks at homeFor the treatment of gout in the period between attacks at home eliminate hyperuricemia, recurrences of gout attacks, prevent damage to internal organs, restore the broken joint function with the help of complex therapy, including drugs, diet, physical influences and sanatorium-It is important not to use long-term medication for gout at home under light attacks, and with a dubious diagnosis. The first two days should be used Colchicine( 1 mg / day) or Indomethacin( 75 mg / day). Before receiving antidotal drugs, the type of impaired purine metabolism is established. It can be metabolic, renal and mixed. Uricostatics inhibit the formation of uric acid, for example, Allopurinol: the daily dose is 100-900 mg, which depends on the degree of hyperuricemia. At a mild degree - 200-300 mg, at an average - 300-400 mg, at a heavy - 600-900 mg / day. For two days you can reduce the level of uric acid by 2-3 times. The drug is used constantly, because it does not have the durability and duration of action. The break is made in the summer for 1-2 months due to the appearance of a variety of plant products in the menu. Uricosuric means inhibits tubular reabsorption of uric acid compounds and increases production, so they are prescribed for renal hyperuricemia. Treat: Etamide, Benzbromarone, Probenecid( BENEMID) and salicylates - 4 g / day. Most often treated with Allamaron, he is convenient in taking - once a day for 1 table.and has a small number of adverse symptoms. Dissolve uric acid stones and prevent the formation of new ones - with the drug Uralit( Magurlit, Blamaren).
Menu for gout: what can you eat?Usually prescribed for gout diet number 6, which has a full calorie, it limits animal fats and salt, reduced the amount of protein. The diet has many alkaline valences and it provides for increased fluid intake. The energy value of the diet is 3000 kcal. Suitable and diet number 5. forbidden to eat:
- by-products: liver, kidneys, tongue, brains.
- with meat of young animals and poultry: veal and chicken.
- with fat varieties of meat and fish, soups and broths from them.
- beans, rich purines: peas, beans, beans, lentils, sorrel and spinach.
- with meat and fish in boiled form 2-3 times a week.
- with milk and dairy products.
- with flour and cereals, white bread( in small quantities).
- vegetables: potatoes, cabbage, zucchini, pumpkin, melons, watermelons.
- fruits: apples, apricots, plums, pears, peaches, oranges.
- berries: grapes, cherries, cherries, strawberries and blueberries.
- before going to bed you need to drink a cup of soft tea, coffee, tea with milk or lemon, juice.
- includes curd, kefir, dairy and fruit-free days.
- on meat days - boiled beef - 150 g or boiled fish - 150 g. You can combine meat and fish and enter that day with vitamin C and B¹.
- during the exacerbation - only liquid food: milk, lactic acid products, kissels, compotes. And also: vegetable and fruit juices, weak tea with milk or lemon, broth of wild rose, vegetable soups, liquid porridges.
Complications of goutGout is indicated by the following complications:
- 1) Gouty glomerulosclerosis and urate stones in the kidneys. Nephropathy, gouty nephritis, pyelonephritis develops.
- 2) Violation of kidney function in violation of purine metabolism( gouty kidney).In the presence of arterial hypertension and diabetes mellitus, acute kidney failure develops.
- 3) Gouty arthritis and destructive polyarthritis with joint deformities.
- 4) Osteoporosis( thinning of bone tissue).
- 5) The formation of tofus on joints or soft tissues: on the wings of the nose, in the auricle, fingers, feet, in the internal organs - the heart, kidneys, etc.
Prophylaxis and prognosisProlonged seizures can result in complete recovery. The prognosis is favorable and depends on the level of hyperuricemia and adequate treatment. People can maintain their ability to work for many years and their quality of life does not suffer. Prevention is reduced to diet, exclusion of fasting, use of diuretics, long-term use of drugs that dissolve urate salts( Uralit), the use of sanatorium treatment. You can apply compresses to the joints of a mixture of valerian( 3 bottles) and cologne( or vodka) - 200 ml. Compress warmed with a woolen scarf. After an exacerbation the status will improve.
Gout: symptoms, development in women and men
Gout stages and their symptoms
As a rule, at night or early in the morning the person learns what gout is: symptoms are painful and unforeseen first time at this time of the day.
The patient experiences a piercing pain, observes redness and swelling at the lesion site, skin becomes red or purplish. The greatest peak of unpleasant sensations is reached in a day or two after the manifestation. Even the usual light touch to the joint causes unbearable pain.
Such an acute attack, it is also called classical, is often accompanied by a significant increase in temperature( up to 38 degrees and above);an insuperable weakness in the whole body. A person feels the heat, then the cold. But after 4-5 days everything passes, sometimes just as suddenly, in some cases gradually. Nevertheless, after a while the pain returns again.
The interval between the first and the subsequent seizure may sometimes reach eight months, with painful periods being short. However, over time, if you do not carry out the proper treatment and prevention, everything changes: seizures become more frequent and longer. At the same time, at some point the pain becomes constant, and the gaps are absent completely.
Tofusi - a characteristic sign of gout
Gout, in contrast to other joint diseases, has its own characteristic - tofusi. These are kind of dense, solid nodules that do not cause pain.
They are formed from uric acid, which took the form of crystals, and accumulate in the periarticular tissues. Often, such yellow nodules appear near the auricles, less often - at the joints of the feet, brushes, tibiae and elbows.
As a rule, in the period of attacks tofusi soften. In some cases, with very advanced stages of gout, these peculiar nodules can erupt. And then through the formed fistula their contents are deduced, that is crystals. Usually, two to three days after the breakthrough, the wound is prolonged without consequences.
Stages of the disease
As you know, gout is a disease that is constantly progressing. In connection with this, its symptoms also change, that is, each stage of the ailment differs somewhat from the previous one. In addition to the classic attack or acute, the following stages are distinguished:
- rheumatoid gout. For her is a characteristic place of damage to the joints: as a rule, these are hands. At the same time, seizures are not as strong as in the classical and their duration varies from a few hours to a day;
- is an asymptomatic gout. The signs of this disease are indistinct, "blurred", the disease develops imperceptibly. Basically, because of the lack of a vivid clinical picture, the patient suffers a minor malaise and does not seek help, which in turn contributes to complication;
- kidney gout. From the very title it is clear that this disease is directly related to a malfunction in the work of the kidneys. As a rule, such patients have already diagnosed pyelonephritis( inflammation of the kidneys).Subsequently, the disease can be complicated by the formation of stones, or at all lead to kidney failure;
- is an allergic gout. It occurs most rarely. Symptoms of such gout are often confused with polyarthritis. A distinctive feature is the rapid development of the signs of the disease, besides inflamed joints have a bright purple hue and become very hard;
- subacute gout. Unlike the classical, the pain with such a subspecies is not so severe. The joints swell more often, but the inflammation itself does not last long. The attack goes by itself, and usually much faster than acute;
- is an arthritic form of gout. In this case, unpleasant sensations appear in the tendons. There is severe pain in the joints of the legs, after a while they begin to deform. This leads to the fact that a person can not move normally. If the treatment is not performed in time, the muscles are involved in the process.
Each of the above diseases can lead to chronic gouty arthritis, which is also referred to as "gouty status."At this stage of the disease, the articular cartilage is destroyed. And in the bones forming the joint, there are special defects - "piercers".This is a kind of cavity, which is filled with microcrystals of uric acid.
Symptoms in women and men: significant differences
Earlier, for quite a long time, gout was considered only a man's disease, as he suffered mostly a strong sex. Nowadays, given that the number of meat products has increased in the diet of women, gout has become more infectious to the fairer sex than a hundred years ago.
This was also promoted by the use of certain drugs, in particular, drugs for high blood pressure. It mainly causes gout symptoms in women who are in the climacteric period. The most common signs include:
- sharp joint pain, which prevents movement;
- redness and swelling in the affected area;
- presence of attacks of acute arthritis;
- there is a general malaise, fever, there is a feeling of nervousness;
- skin peeling.
Meanwhile, gout in women is much easier than in men .Very rarely there are acute gouty attacks, tofuses and piercers in the bones are also not often observed. Signs characteristic of female gout are blurred chronic pain in the ankle and knee. The only thing that distinguishes such an ailment from arthrosis is a strong puffiness of the affected joint.
Symptoms of gout leg
If you take into account the joints of the lower extremities, then most often the gout affects the big toes. As a rule, the disease shows a sharp pain and redness in the area of the finger. Such signs are the result of inflammatory processes occurring in the joint. The symptoms appear, suggesting that the deposition of uric acid crystals began.
In addition to the fingers, extremely unpleasant sensations the patient can also experience in the knee and ankle. In addition to them, with the naked eye, reddening of the skin and swelling are visible. There is also fever and chills, replacing each other. With such a disease, the duration of an attack can range from an hour to several days.
Acute inflammatory process caused by the deposition of calcium pyrophosphate crystals is a pseudogout. Pseudo means false, because its symptoms are very similar to the true gout.
In both cases there is accumulation of crystals, only with gout accumulates salts of uric acid. Also, with a true disease, pain is much more acute, and the outcome is less favorable.
Pseudogout is also called pyrophosphate gout. The patients of older age groups, who often have two or three large joints, are the most susceptible to this disease. A characteristic manifestation of the disease - calcification of articular cartilage is determined by means of X-ray examination.
Causes of the disease
Depending on the causes of the onset, specialists identify three forms of the disease, which is caused by the deposition of calcium pyrophosphate:
- hereditary predisposition;
- is an idiopathic form, that is, associated mainly with aging;
- form, resulting from metabolic disorders - decreased thyroid activity( hypothyroidism), excess iron in the body( hemochromatosis), a large amount of calcium in the blood( hypercalcemia).
The reason why calcium crystals begin to accumulate in the cartilage is not exactly established. Practically every person can have this process. Nevertheless, there are several factors that significantly increase the risk of the disease. These include:
- recent surgical intervention - operation on the joint;
- joint injury;
- the patient has renal failure, diabetes.
Symptoms of the disease
Has pseudogout symptoms very similar to other joint diseases. As a rule, at times of attacks, especially severe pain can be felt in the knee area. Also, the disease affects wrists, elbows, hands, shoulders, ankles. Symptoms manifest themselves in different ways. Most patients complain of severe pain, which is accompanied by limited movements and swelling in the joint area.
In some cases, a person experiences painful attacks of arthritis, in others - chronic pain, as well as stiffness in the joints of the limbs. Quite often, there are no symptoms at all between attacks. It happens that there are no painful sensations, although a significant deposition of calcium crystals in the joint is clearly seen on X-rays.
In numerous photos, gout symptoms is very similar to pseudo-red: redness and swelling. Therefore, only a specialist can determine the disease correctly. And, the earlier the treatment is started, the more favorable it will be. Otherwise, the ailment can lead to chronic disability.