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Acute gouty arthritis
Alternative namesGouty arthritis - acute; Gout - acute
DefinitionAcute gouty arthritis is an attack of a metabolic disease marked by uric acid deposits in the joints. The disorder causes painful arthritis , especially in the joints of the feet and legs.
Causes, incidence, and risk factors
Gout is caused by a defect in metabolism that results in an overproduction of uric acid , or a reduced ability of the kidney to eliminate uric acid. The exact cause of the metabolic defect is unknown. The condition may also develop in people with diabetes , obesity , sickle cell anemia , and kidney disease , or it may follow drug therapy that interferes with uric acid excretion.
In acute gouty arthritis, symptoms develop suddenly and usually involve only one or a few joints. The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating. The joint appears infected with signs of warmth, redness, and tenderness.
The attacks of painful joints may subside in several days, but may recur at irregular intervals. Subsequent attacks usually have a longer duration. Some people may progress to chronic gouty arthritis , while others may have no further attacks.
Signs and testsA physical examination of the joints shows acute arthritis.
The following tests might also be helpful:
The goals of treatment are mainly to stop the pain and inflammation associated with the initial attack, and to prevent future attacks.
Colchicine is one of the medications that is effective in reducing the pain, swelling, and inflammation associated with acute gout attacks. The pain often subsides within 12 hours of starting treatment, and is completely relieved in 48 hours.
The medication works by decreasing the inflammation caused by uric acid crystals within the joint. However, it does not decrease the uric acid levels in the bloodstream. Daily use of colchicine or allopurinol helps prevent future attacks.
Non-steroidal anti-inflammatory drugs (NSAIDs) can be very effective in treating the pain and inflammation of an acute gout attack if taken soon after symptoms start.
Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
Codeine or other analgesics may occasionally be prescribed for pain relief. Increased fluid intake prevents the formation of kidney stones .
Expectations (prognosis)Adequate treatment of acute attacks allows people to live a normal life. The acute form of the disease may progress to chronic disease. Since uric acid is normally eliminated by the kidneys, chronic gout may lead to formation of uric acid kidney stones.
Calling your health care providerCall for an appointment with your health care provider if symptoms occur that are suggestive of acute gouty arthritis.
PreventionThe disorder itself may not be preventable, although some precipitating factors may include trauma, alcohol consumption, and dietary purines. Medications may reduce attacks in a person with gout.
Update Date: 8/6/2003Megan E. B. Clowse, M.D, M.P.H., Division of Rheumatology, Johns Hopkins Hospital, Baltimore, MD. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT