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🔥+ center for arthritis rheumatic 07 Jul 2020 Did he have any redness or swelling in the painful joints, the rheumatologist asked. Never ... She noticed that his fingernails had tiny longitudinal ridges, ... started the patient on a medication used to treat inflammatory arthritis.

center for arthritis rheumatic Repeated attacks of gouty arthritis, or "flares," can damage the joint and lead to chronic arthritis. Fortunately, while gout is a progressive disease, there are effective ...

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Gout (gouty the 1 last update 2020/07/07 arthritis) factsGout (gouty arthritis) facts

  • Gout is a type of arthritis that causes inflammation, usually in one joint, that begins suddenly.
  • Gouty arthritis is caused by the deposition of needle-like crystals of uric acid in a joint.
  • Gout symptoms and signs include
  • The most reliable method to diagnose gout is to have fluid removed from an inflamed joint and examined under a microscope for urate crystals.
  • Chronic gout is treated using medications that lower the uric acid level in the body.
  • Left untreated, gout can cause irreversible joint damage, kidney problems, and tophi.
  • Triggers for acute attacks (flare-ups) of gout include surgery, dehydration, beverages sweetened with sugar or high fructose corn syrup, beer, liquor, red meat, and seafood.
  • Cherries may help prevent gout attacks.

Gout Diet

The primary dietary goal for gout is to limit your intake of foods with high amounts of purinein them. Ideally, you will have little or no foods that are high in purine and only small amounts of those with moderate amounts of purine.

Foods considered high in purine the 1 last update 2020/07/07 content include the following:Foods considered high in purine content include the following:

  • Some fish, seafood and shellfish, including anchovies, sardines, mackerel, scallops, herring, mussels, codfish, trout, and haddock
  • Some meats such as bacon, turkey, veal, venison, liver, beef kidney, brain, and sweetbreads
  • Alcoholic beverages
center for arthritis rheumatichow to center for arthritis rheumatic for the 1 last update 2020/07/07 Source: MedicineNetSource: MedicineNet

What is gout?

Gout is a type of arthritis that causes sudden joint inflammation, usually for 1 last update 2020/07/07 in a single joint. Severe gout can sometimes affect many joints at once. This is known as polyarticular gout.Gout is a type of arthritis that causes sudden joint inflammation, usually in a single joint. Severe gout can sometimes affect many joints at once. This is known as polyarticular gout.

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What causes gout?

Gout is caused by too much uric acid in the bloodstream and accumulation of urate crystals in tissues of the body. Uric acid crystal deposits in the joint cause inflammation of the joint leading to pain, redness, heat, and swelling. Uric acid is normally found in the body as a byproduct of the way the body breaks down certain proteins called purines. Causes of an elevated blood uric acid level (hyperuricemia) include genetics, obesity, certain medications such as diuretics (water pills), and chronic decreased kidney function (kidney disease).

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What are risk factors for gout?

There are many risk factors for gout. Having high blood pressure is a risk factor for gout. Gout is more common after surgery, trauma, and dehydration. Certain medications such as diuretics (commonly known as water pills), which treat high blood pressure, that raise the level of uric acid in the bloodstream are risks for gout. Surprisingly, medications that lower the level of uric acid in the bloodstream, such as allopurinol (Zyloprim, Aloprim), can also initially cause a flare of gout. This is because anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint. Low-dose aspirin can precipitate gout attacks. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed. Degenerative arthritis also makes affected joints more likely to be the site of a gouty attack.

SLIDESHOW

Gout Attack Symptoms, Causes, Treatment, and Diet See Slideshow
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What are gout symptoms and signs?

The characteristic symptoms and signs of gout are

These symptoms and signs usually affect a single joint. The pain is typically severe, reflecting the severity of inflammation in the joint. The affected joint is often very sensitive to touch to the point that some people with gout attacks experience pain from something as simple as pulling the bedsheets over the inflamed joint. The affected joint becomes swollen. The medical term for excessive fluid in a joint is a "joint effusion."

Gout frequently involves joints in the lower extremities. The classic location for gout to occur is the big toe (first metatarsophalangeal joint). Podagra is the medical term for inflammation at the base of the big toe. Gout can also affect the foot, knee, ankle, elbow, wrist, hands, or nearly any joint in the body. When gout is more severe or longstanding, multiple joints may be affected at the same time. This causes pain and joint stiffness in multiple joints.

center for arthritis rheumatichow to center for arthritis rheumatic for Another sign of gout is the presence of tophi. A tophus is a hard nodule of uric acid that deposits under the skin. Tophi can be found in various locations in the body, commonly on the elbows, upper ear cartilage, and on the surface of other joints. When a tophus is present, it indicates that the body is substantially overloaded with uric acid. When tophi are present, the uric acid level in the bloodstream typically has been high for years. The presence of tophi indicates tophaceous gout and treatment with medications is necessary.

center for arthritis rheumatichow to center for arthritis rheumatic for Longstanding untreated gout can lead to joint damage and physical deformity.

Kidney stones may be a sign of gout as uric acid crystals can deposit in the kidney and cause kidney stones.

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What types of doctors treat gout?

Rheumatologists traditionally have expertise in diagnosing and treating gout, especially complicated situations. Other specialists such as internists, general practitioners, family medicine doctors, and orthopedists can manage straightforward cases of gout. Nephrologists may treat patients with uric-acid-lowering medications such as allopurinol in order to prevent damage to the kidneys, which can occur with elevated uric acid levels (hyperuricemia).

How do health care providers diagnose gout?

The most reliable method to diagnose gout is by demonstrating uric acid crystals in joint fluid that has been removed from an inflamed joint (arthrocentesis). Specially trained physicians, such as a rheumatologist or orthopedist, can carefully remove fluid from the joint. The fluid is then examined under a microscope to determine if uric acid crystals are present. This is important because other medical conditions and diseases, such as pseudogout (a type of arthritis caused by the deposition of calcium pyrophosphate crystals) and infection, can have symptoms similar to gout.

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Do gout medications have any side effects?

  • Gout medications are well tolerated by most people. However, like other medications, they have potential side effects.
  • Allopurinol is well tolerated by most people, but in some people, it can cause an allergic rash. Very severe rashes rarely can occur after taking allopurinol, and any allergic type rashes that develop while a patient is taking allopurinol are taken seriously.
  • Colchicine (Colcrys) can cause signs and symptoms such as nausea, diarrhea, and rarely muscle weakness and abnormal blood counts.
  • Probenecid is generally well tolerated but should not be used in patients who have uric acid kidney stones, as it can worsen the kidney stones and potentially harm the kidneys in these patients.
  • Febuxostat (Uloric) can cause liver abnormalities, nausea, and rash.
  • NSAIDs can cause irritation of the stomach and ulcers in some cases. The liver and the kidneys are periodically monitored in patients taking NSAIDs over the long term.
  • Krystexxa is administered as an intravenous infusion. Severe allergic reactions have been reported in a minority of people receiving Krystexxa.
for 1 last update 2020/07/07

QUESTION

Gout is the 1 last update 2020/07/07 a form of arthritis.Gout is a form of arthritis. See Answer
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center for arthritis rheumatichow to center for arthritis rheumatic for What foods should people with gout eliminate from their diet?

Uric acid is formed when proteins in the food we eat, called purines, are broken down. Therefore, there has been for 1 last update 2020/07/07 a great deal of interest in dietary management of gout by avoiding high-purine (purine-rich) foods. However, a diet very low in purines is extremely difficult to follow, because purines are a natural part of many healthy foods. Even when a diet very low in purines is followed strictly, the uric acid level in the bloodstream is only slightly lowered.Uric acid is formed when proteins in the food we eat, called purines, are broken down. Therefore, there has been a great deal of interest in dietary management of gout by avoiding high-purine (purine-rich) foods. However, a diet very low in purines is extremely difficult to follow, because purines are a natural part of many healthy foods. Even when a diet very low in purines is followed strictly, the uric acid level in the bloodstream is only slightly lowered.

The following dietary principles are important in the management of gout:

  • Gout is associated with obesity, and significant weight loss can dramatically improve the management of gout. A calorie-reduced diet is helpful for weight loss.
  • A diet low in saturated fat, with increased protein and replacement of refined carbohydrates (for example, sugar, white bread, potatoes) with complex carbohydrates (such as vegetables and whole grains) reduces the serum uric acid.
  • Decreased consumption of seafood and red meat.
  • The consumption of low-fat dairy products decreases the risk of gout.
  • Drinking beer and liquor increase the risk of gout. However, drinking wine does not appear to increase the risk of gout.
  • In one study, consumption of fresh cherries was associated with a 35% decreased risk of gout. Some people believe that black cherry juice or dried cherries have the same effect, but this has not been proven.
  • Drinking beverages sweetened with sugar or high fructose corn syrup increases the risk of gout.

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What complications are associated the 1 last update 2020/07/07 with gout?What complications are associated with gout?

Longstanding untreated gout can cause irreversible joint damage.

Uric acid can deposit in the kidneys and cause kidney stones and decreased kidney function.

Uric acid can deposit in the soft tissues, especially around joints, and cause nodules known as tophi, which can be large and unsightly.

center for arthritis rheumatichow to center for arthritis rheumatic for What is the prognosis of gout?

Gout is a chronic condition. Left untreated, patients may suffer from recurrent painful and disabling acute attacks of gout. Joint damage and other complications of gout may occur. However, excellent treatments for gout are available, and most patients respond very well to gout treatment with a good prognosis.

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the 1 last update 2020/07/07

Is it possible to prevent gout?

Some of the risk factors for gout are genetic, and those are not preventable. However, many of the risk factors for gout, such as obesity and diet, are controllable. Maintaining a healthy weight and a diet low in refined carbohydrates and low in saturated fat and red meat may prevent gout.

What is the latest research on gout?

Research is being done on using medications that block a chemical signal known as interleukin-1 to treat gout flares in patients who do not respond to other therapies. Anakinra (Kineret) and canakinumab (Ilaris) are two medications that block interleukin-1. They are currently used for other conditions and are under investigation for use in gout flare-ups.

There is ongoing research in using a specialized CT scan known as a dual energy CT scan to diagnose gout. There is also a great deal of research investigating the various uric acid transporter genes that are responsible for uric acid metabolism.

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Medically Reviewed on 2/6/2020
References
Choi, H.K. "" Current Rheumatology Reports 7.3 June 2005: 220-226.

Firestein, G.S., et al. Kelley''s own disease-fighting arsenal; rising body temperatures apparently are capable of killing off many disease-producing organisms.
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