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Skip to Content. What can we help you with? Knowledge Center Articles Why Gout? Knowledge Center. Several factors put people at greater risk for developing gout: More common in men between the ages of 30 and 45 Family history of gout Health conditions such as high blood pressure, diabetes or kidney disease Some medications Overweight Drinking too much alcohol, especially beer, and sugary sodas It is important to come to Direct Orthopedic Care for diagnosis if experiencing gout symptoms.
Long-term medications are typically prescribed to patients who have: More than three gout attacks a year Severe and disabling gout attacks Gouty joint arthritis Tophi Kidney damage or repeated kidney stones People who develop destructive arthritis related to chronic gout may be helped with surgery.
Previous Article. Next Article. Read more here about how gout can progress over time. A rheumatologist is a specialist who treats musculoskeletal disease and systemic autoimmune conditions, including gout.
First, your doctor will perform a physical examination to assess your overall health and ask about your history of joint pain and other symptoms that suggest gout, as well as your family history and any pre-existing medical conditions you have or medications you take.
The doctor may check for pain in multiple joints. Along with assessing your medical history and your symptoms, your rheumatologist will want to hear about any possible risk factors for gout. Read more here about common gout risk factors and how they may affect you. If your score is 4 or less, your likelihood of gout is low. If your score is 8 or above, you have a high probability of a gout diagnosis.
Your provider will likely order a series of laboratory tests that help point to gout or rule out other conditions to make a final diagnosis. The ideal way to diagnose gout is to draw fluid out of the joint and have the fluid examined for the presence of uric acid crystals under the microscope, with a special attachment called a polarizer, says Dr. After using a local anesthetic to numb the soft tissue over the joint, the doctor will insert a needle into the joint space to extract a sample of fluid.
The fluid is sent to the lab for analysis and may even be viewed by your doctor. Your doctor will probably use a blood test to help determine whether you have gout.
In fact, between 12 and 43 percent of people have low to normal uric acid levels during a gout flare, according to UpToDate. As well, you can have high uric acid levels but not have painful gout symptoms. This is a condition called asymptomatic hyperuricemia. Imaging tests, including X-ray, ultrasound, and computed tomography CT , can help doctors rule out other health conditions and check for tophi, crystal deposits, and fluid accumulation, which are all characteristic of gout.
An x-ray can reveal whether you have any tophi under the skin as well as whether you have any bone erosions due to tophi, which are characteristic of chronic gout. It can also be used to rule out a fracture in your toe or other joint. These can show any crystal deposits, fluid accumulation, or narrowing of the joint space due to cartilage loss. A dual-energy CT scan can be used to distinguish urate crystals a telltale sign of gout from calcium crystals common in another condition known as pseudogout.
If you are overweight, have sudden, sharp pain in your big toe at night, your blood test reveals high uric acid levels, and you tend to eat a diet rich in meat and seafood and drink alcohol excessively, gout is likely the culprit.
But a gout diagnosis is not always that straightforward. Instead, the symptoms occur in multiple joints and can mimic other conditions, including:. Read more here about common gout misdiagnoses.
Recurrent gout is treated non-surgically and most often controlled with medications that lower uric acid levels and prevent attacks. Activity modification, dietary changes and adjustment to certain medications can help reduce the buildup of uric acid in the blood. In these rare cases, surgery is necessary. Otherwise, the treatment is activity modifications, dietary changes, and medication adjustments to reduce the buildup of uric acid in the blood.
The link between certain foods and gout is unclear. Some studies point to alcohol, fructose sweetened drinks, meats, and seafood, while others come up with the opposite results. In some cases, too much activity in a short period of time and dehydration can lead to a gout flare up. There is some good evidence that coffee, vitamin C, dairy products, and cherries can reduce the risk of gout. Also, regular physical exercise seems to diminish the risk. Other specialists, like a rheumatologist, can help ease the pain and prevent further damage.
Gout is an incredibly painful and chronic form of arthritis that has been around since ancient times. People with gout can expect to experience problems directly and indirectly related to the disease. Because of this, it is important to have a gout treatment team available to make sure you are staying on top of your gout and limiting the harm it does to your body.
But primary care physicians and other internists often aren't as aggressive as they could be in gout treatment, Edwards says. They focus on alleviating pain through anti-inflammatory drugs, but may not pay enough attention to the real cause of gout , the build-up of uric acid in the bloodstream and joints.
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