What is gout?
Gout is a disease of joint (arthritis) which is caused by excess of uric acid in the blood. Uric acid in the blood is produced by breakdown of a type of protein” purine”. Level of uric acid in the blood is increased in many disease like hypothyroidism, psoriasis, kidney disorders, in some cancers, and if you are drinking too much alcohol. Certain drugs like diuretics (common drug for increased BP) can also increase blood uric acid level. Other conditions which can lead to raised blood urate (uric acid) level are tumor lysis syndrome, and inherited deficiency of certain enzymes which are necessary for uric acid breakdown in the body.
What happens in the gout?
High uric acid levels for prolonged period can cause deposition of uric acid crystals in tissues like around joints (known as tophi), in the kidney etc. This results in painful, warm and swollen joints and kidney stones. Although raised uric acid level is a sine qua non for the development of gout, all patients with the disease may not have raised uric acid levels. Also 5% of normal population have raised uric acid level and don’t suffer with gout. Attacks of gout (swollen painful and tender joints) are more associated with fluctuation in the blood uric acid level rather than absolute high value, so normal uric acid level is quite common during attacks of gout.
Why measuring blood uric acid level is important?
The higher the serum urate levels, the more likely an individual is to develop gout. Also with initiation of treatment blood uric acid level should go down so its monitoring is used to assess the effect of treatment.
Symptoms and signs of gout:
A patient of gout has recurrent acute attacks of gout before developing chronic gouty arthropathy. After many years of recurrent acute attacks patient develops chronic arthropathy. Acute attack is characterized by red, tender, warm and swollen joint. The attack may be precipitated by local trauma, stress, acute illness, unaccustomed exercise or alcoholic binge. Junction of great toe to foot is most commonly involved joint. Other joints like the ankle, small joints of hand, knee and elbow may be involved. Chronic gouty arthritis is characterized by stiff, painful and deformed joints.
Acute attack of gout involving great toe.
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मेरा दाए पैर में चोट लगने के कारण टेढ़ा हो गया था जिसकी वजह से मुझे चलने में भी परेशानी हो रही थी. डॉ जितेश ने ऑपरेशन कर के इसे सीधा किया. में बिलकुल ठीक हूँ .
मेरी बेटी के घुटने में इन्फेक्शन होने के कारण वो दर्द की वजह से सो भी नहीं पाती थी. डॉ जितेश ने ऑपरेशन कर के इसे ठीक किया. बहुत धन्यवाद।
I remember that Dr. Jain came out from his clinic to see my mother because my mother was not able walk a single step. He did total knee replacement on both side and now my mother is walking without aid.
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