When Does Gout Develop?

Gout occurs when urate crystals start to build up within the joints. High levels of uric acid in a person’s blood can lead to the formation of urate crystals. Purines — a substance that your body naturally has — is also found in different foods such as steak, seafood, and alcoholic beverages. When your body is breaking them down, it produces uric acid.

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Preventing Gout

There are some guidelines to follow to reduce the risk of gout:

  • Avoid or limit alcohol
  • Drink plenty of water
  • Limit the intake of foods that contain purines
  • Achieve and maintain a healthy body weight

Causes of Gout

Under normal circumstances, the uric acid dissolves and is excreted through the urine. However, if the body is producing too much uric acid or the kidneys aren’t excreting it efficiently, it can start to accumulate. If this happens, the crystals that it can form are needle-like and sharp.

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Factors That May Increase Gout

A person’s risk of developing gout may be heightened by the following:

  • Obesity
  • Being male
  • Being age 30-50
  • Family history of gout
  • Recent surgery or trauma
  • Eating a diet rich in foods that contain purines
  • Certain medical conditions (such as metabolic syndrome, high blood pressure, kidney or heart disease, and diabetes)
  • Certain medications (such as organ transplant anti-rejection medications and thiazide diuretics)

Symptoms of Gout

The symptoms of gout usually come on quickly, with little warning. In many cases, they start at night. The following are the possible symptoms:

  • The joint pain is usually intense. Any joint can be affected, but it is usually the big toe. Other joints that are commonly affected include the knees, wrists, ankles, elbows, and fingers. Within the first 12 hours of the attack, the pain is typically the most severe.
  • The affected joint can appear red. This is due to gout causing inflammation. The joint might also become tender, warm, and swollen.
  • Once the severe pain starts to go away, it is possible for some discomfort to linger. This lingering pain can last up to a few weeks for some people.
  • As this condition progresses, people might find that their range of motion becomes limited. For example, with gout in the big toe, it may be hard to move the toe up or down.
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Complications

Once someone has one episode of gout, they are at risk for future attacks. In some cases, recurrent attacks can happen up to several times per year. With recurrent attacks comes the risk of joint destruction or erosion. 

It’s also possible for the crystals that occur with gout to also develop in the kidneys and urinary tract, which could lead to kidney stones.

In addition, when gout is not treated, it can become more advanced. At this point, it is possible to develop tophi — a type of nodule that may occur under the skin. The common areas for these nodules include the fingers, elbows, feet, hands, and along the Achilles tendon.

Diagnosis

It is important to make an accurate diagnosis of gout so that the right treatment can be administered. In addition to a physical examination of the affected joint, the following might be performed:

  • Blood testing to evaluate uric acid levels
  • Ultrasound to look for tophi or urate crystals
  • Joint fluid testing to look for crystals
  • X-rays to look at the joint
  • Dual energy CT scan to look for urate crystals
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Treatment

At Foot & Ankle Specialty Group, we address gout with several treatments. Medications are the typical course of treatment for gout. The following may be prescribed:

  • Uricosuric medications: These can help to improve how well the body removes uric aci
  • Xanthine oxidase inhibitors: These can help to reduce the uric acid production in the body.
  • Colchicine: This is used to reduce gout pain. Once the acute phase of a gout attack ends, this medication might be prescribed at a lower dose to help to prevent recurrent gout.
  • Non-steroidal anti-inflammatory drugs: These medications can reduce inflammation to alleviate a patient’s gout pain. During an attack, the dose may be higher.
  • Corticosteroids: May used short-term orally or via injection to reduce pain.
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Gout Treatment at Foot & Ankle Specialty Group

If you suspect that you have gout, it’s important to see your doctor promptly in order to reduce the frequency and severity of the attacks. It’s also important to take advantage of any preventative methods to reduce the risk of attacks. At Foot & Ankle Specialty Group, we can help with this condition. 

Since 2001, Dr. Salma Aziz has been a staple of the Rancho Santa Margarita and Newport Beach community, and she has built her reputation on time-tested practices. In addition, our other foot and ankle specialists, Dr. Petrina Yokay and Dr. Jessica Arneson, bring their own strengths and areas of expertise to our podiatry clinic. Our practice is about getting people back to their activities and life.

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