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Chronic gouty arthritis
Alternative namesGout - chronic; Gouty arthritis - chronic
DefinitionGouty arthritis is the name for an attack of a metabolic disease marked by uric acid deposits in the joints. The disorder causes pain, especially in the joints of the feet and legs. Patients with chronic gout may have repeated episodes of gouty arthritis.
Causes, incidence, and risk factorsGout is caused by a defect in metabolism which results in an overproduction of uric acid or leads to reduced ability of the kidney to eliminate uric acid. The exact cause is unknown. Risk is increased in males, postmenopausal women, and people with hypertension. Heavy alcohol use, diabetes, obesity, sickle cell anemia, and kidney disease also increase risk, as does lack of preventative measures in those with prior attacks.
The condition may also develop in people who take drugs which interfere with uric acid excretion.
Signs and testsThere may be a current or previous medical history of acute arthritis in one joint. A physical examination of joints shows arthritis and tophi.
Tests that indicate gouty arthritis include:
TreatmentChronic gouty arthritis is treated with drugs like probenecid or sulfinpyrazone, which reduce uric acid levels. Another approach is to use allopurinol, which blocks the enzyme that produces uric acid, helping to reduce the level of this chemical. Patients should drink plenty of water or other fluids to decrease the risk of kidney complications.
Colchicine can be added to prevent further acute attacks. This drug can be discontinued when uric acid levels are stable (usually after 3 months), but it can also be continued at low doses to help prevent further attacks.
Support GroupsThe stress of illness may be eased by joining a support group of members who share common experiences and problems. See arthritis - support group .
Expectations (prognosis)Symptoms are generally worse in people who develop the disease before age 30.
Calling your health care providerCall your health care provider if symptoms of chronic gouty arthritis develop.
PreventionDrugs that lower the serum uric acid concentration may prevent the development of chronic gouty arthritis in susceptible people.
Update Date: 10/24/2003Stanford Peng, M.D., Ph.D., Division of Rheumatology, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT