What is Gouty Arthritis: Progression, Stages, Symptoms, Diagnosis and Treatment

What is gout?

Gout is a rheumatic disease of arthritis that is characterized by (elevated levels of uric acid) hyperuricemia, inflammation and pain.

It has been described throughout history as the “King’s Disease.” This is because high levels of uric acid are often caused by the intake of food such as wine, red meat and shrimp.

Progression of the disease

The patient often experiences an initial period of asymptomatic hyperuricemia , in which if the levels are not reduced, an episode of acute gouty inflammation will occur over time. High levels cause the formation of uric acid crystals, which causes damage to the joints. The inflammation can cause damage to the cartilage, bone, bursa, tendons and organs such as the kidneys and the heart.

The three stages of the Drop are:

  1. Asymptomatic hyperuricemia: Uric acid levels are elevated, but symptoms have not yet appeared
  2. The initial gout attacks: appearance of acute gouty arthropathy. The intervals between acute attacks may decrease if uric acid levels are not controlled.
  3. Chronic gout: It is characterized by the formation of tophi, which are caused by crystal deposits.

Potential complications associated with uncontrolled droplet

  • Hypertension.
  • Chronic kidney disease.
  • Congestive heart failure.
  • Metabolic syndrome.
  • Type 2 diabetes mellitus.
  • Atherosclerosis

Symptoms of an acute attack of gout

  • Severe pain, which occurs in the affected joint.
  • The first attack almost always starts at the first joint (big toe).
  • Red and shiny skin of the affected area which may feel warm to the touch.
  • Forms of uric acid in crystals, accumulating in small joints.
  • The area becomes very painful. Complications, including disfigurement, can occur, and in severe cases, can lead to back pain due to compression of the spinal cord.

Progressive Drop Attacks

  • Chronic inflammation progresses to a chronic phase.
  • More affected areas are found.
  • Start from the fingers progressing to the knees, elbows and hands.
  • This can cause irreversible joint deformation.

How is Gouty Arthritis diagnosed?

Signs such as pain and swelling in the big toe will lead the doctor to suspect gouty arthritis, ordering confirmatory blood tests. Uric acid should also be monitored through a urinalysis and a 24-hour test. Basal levels should be obtained to control kidney function.

Changes in diet and lifestyle

Increased fluid intake: staying hydrated helps eliminate uric acid. Avoid foods rich in purines

Pharmaceutical Treatment

Allopurinol: A pill that is taken to control gout attacks by attenuating the production of uric acid.
Colchicine: taken daily for the prophylaxis of recurrent gout attacks to control inflammation, but has no analgesic properties.

It can be administered once every 6 hours for the initial treatment of an attack. Common side effects include diarrhea, abdominal cramps and nausea

Non-steroidal anti-inflammatory drugs (NSAIDs): They can be used to fight inflammation, but because they are so heavy, they should be administered with food.

Corticosteroids: Low doses of maintenance regimens of prednisolone or methylprednisolone can be used to control inflammation.