Gout is the change in the joints caused by a systemic disease in which uric acid crystals build up in the joints of the body, causing inflammation, swelling and pain. This condition may develop for two reasons. The body may produce more uric acid than it can excrete in the urine, or there is a normal amount of uric acid produced, but the kidney's do not filter the proper amount. In both cases a condition called hyperuricemia results. Over time, the uric acid begins to crystallize and settle in the joint spaces, most commonly the first metatarsal phalangeal joint of the big toe.
The most common symptoms of gout are inflammation, swelling and tenderness in the joint of the first toe. Touching or moving it will be intensely painful. Patients often say it hurts to have as much as a bed sheet rest on top of a gouty toe. Attacks of gout develop quickly rather than gradually, and typically occur in only one joint in the body at a time. Acute attacks of gout will resolve with no treatment in 7 to 10 days but this is usually not acceptable due to the intensity of the pain. In some cases, gouty symptoms develop in two or three joints simultaneously, but this is rare. If symptoms occur more widespread than that, it is probably not gout.
Most of the time the diagnosis is made by history of the pain, but the most reliable way to diagnose gout is to examine the patient's joint fluid for uric acid crystals. This is done by drawing fluid from the joint with a needle and examining it under a special polarized light microscope. Although the test is invasive, its results are definitive, and a positive reading will facilitate proper treatment and quick relief.
Gout is fairly simple to treat. If too much uric acid is present, steps should be taken to decrease it. Normally, gout is not treated unless a patient experiences frequent attacks. The acute attack of gout is usually treated by an oral anti inflammatory medication. Following resolution of the acute attack, blood and urine samples are taken to determine if your body produces to much or does not filter enough uric acid. Once this is determined appropriate medications are prescribed to control uric acid levels in the body. Many times a special diet is also recommended to reduce the intake of dietary purines that can increase the amount of uric acid produced by the body. Although medication and diet may make it possible to live with gout, the continued accumulation of uric acid crystals in the joints eventually will damage them to the point where movement will be seriously inhibited.