Gout is the initial attack of a metabolic disease marked by uric acid deposits in the joints. The disorder causes painful arthritis, especially in the joints of the feet and legs.
Causes, incidence, and risk factors Gout is caused by a defect in metabolism that results in an overproduction of uric acid, or a reduced ability of the kidney to eliminate uric acid. The exact cause of the metabolic defect is unknown. The condition may also develop in people with diabetes mellitus, obesity, sickle cell anemia, and kidney disease, or it may follow drug therapy that interferes with uric acid excretion.
Gout has four stages Asymptomatic (without symptoms), acute, intercritical, and chronic. In acute gouty arthritis, symptoms develop suddenly and usually involve only one or a few joints. The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating. The joint appears infected with signs of warmth, redness, and tenderness. The attacks of painful joints may subside in several days, but may recur at irregular intervals. Subsequent attacks usually have a longer duration. Some people may progress to chronic gouty arthritis, while others may have no further attacks. Risk is increased in males, postmenopausal women, and people with kidney disease, diabetes mellitus, sickle cell anemia, or obesity. The incidence is 5 out of 1000 people.
Prevention The disorder itself may not be preventable, although some precipitating factors may include trauma, alcohol consumption, and dietary purines. Medications may reduce attacks in a person with gout.
Symptoms The following symptoms are often noticed when a person is affected by Gout:
- Joint pain begins suddenly in one or more joints (hip pain, knee pain, ankle pain, foot pain, shoulder pain, elbow pain, wrist pain, hand pain, or pain in other joints).
- The great toe, knee, or ankle joint are most often affected.
- Joint swelling of any of the above joints, stiffness of the joint.
- The joint may be warm and red fever may be present.
- Skin lump over a joint.
- Chalky material draining out of the lump.
- Finger pad abnormalities.