What do Dick Cheney, Ansel Adams, Ben Franklin, Sir Isaac Newton and King Henry VIII all have in common? It is true they are all men but not what we are looking for. They are all popular pubic figures but again not the answer. Do you give up? They have all suffered from …. Gout! This condition does not affect only famous males but 1-2% of the western population will suffer from the condition at some point in their lifetime.
Gout is an acute inflammatory arthritis that was historically known as “the disease of kings” or “rich man’s disease” but rates have doubled in the past 20 years and are seen in all areas of society. Typically the condition presents with a hot, red, swollen, tender joint. It involves the big toe most frequently (>50% of case) but can also affect the heels, knees, wrists and fingers. An acute gouty episode is triggered by elevated levels of uric acid in the blood (hyperuricemia) which leads to crystal formation that gets deposited in the joints. Men are most at risk but women are becoming more and more susceptible.
Attacks are known to come on quickly and will usually resolve in 7-10 days but you should seek medical attention and not try to wait it out. The diagnosis can be made clinically but routine blood work should be performed to confirm the uric acid level and x-rays should be taken to make sure there is no fracture. Definitive diagnosis requires joint aspiration to test for the presence of urate crystals. Persons with untreated gout may be a higher risk for cardiovascular disease, kidney dysfunction and more severe permanent joint damage.
Acute treatment consists of ice and rest as well as NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as Indomethacin or Ibuprofen to alleviate the inflammation or Colchicine and steroids for those who can not take NSAIDs. In cases of recurrent or chronic gout, Allopurinol is started 1-2 weeks after symptoms subside and decreases the amount of uric acid produced by the body. Prevention can also be achieved by changing the diet to avoid foods rich in purines (meats, seafood, and lentils) as well as staying hydrated and not consuming too much alcohol or tea.
So you don’t have to be a man or a rich monarch to experience a gouty attack. In today’s society, men and women alike are at risk. Eating a balanced diet and avoiding foods that are high in purines in addition to a healthy lifestyle and plenty of exercise just might save you from a red, swollen, and painful joint. If you are concerned that you are having or have had a gouty episode call us at North Texas Foot & Ankle (972-574-9255) for a consultation.