(Specialist Orthopaedic Surgeon)

Uric Acid Arthritis

What is Gout?

In normal people some amount of uric acid is always found in the blood. This remains in dissolved form. In people suffering from gout there is excess uric acid in the blood which crystallizes in one or more joints in the body. These excess needle shaped crystals of uric acid cause immense irritation in the joint. The result is pain and swelling of the joint.

How is uric acid formed?

Uric acid is formed from a class of protein called purines. It is a natural breakdown product of this protein. This conversion is done in our liver and small intestine. This uric acid is excreted out of our body through the kidneys. In normal people there is good balance between formation and excretion of uric acid.

What are the signs and symptoms ?

Sudden onset of severe pain and swelling in one or more joint is hallmark of gout. Usually this occurs overnight. Common joints involved in gout are first meta-carpo phalangeal joint (base of great toe), knee joint and ankle joint.

This pain usually subsides in 7-10 days. This pain might stay longer in repeated attacks of gout (chronic gout). Pain gets dramatically relieved with pain-killers.

It is more frequently seen in middle aged men and in some women after menopause.

Diagnosis of gout

Diagnosis can be made by the typical clinical presentation.

Confirmation of diagnosis is done by one or more investigations:

  • Increased uric acid in the blood
  • Polarized microscopy
  • X-Rays

Sometimes more blood tests are done to check if you have other type of arthritis.

Do I have gout?

You might be suffering from gout if you have the above mentioned symptoms. It’s very important to consult an orthopedic surgeon if you are having these symptoms as delay in treatment can cause permanent damage to your joints.

Some people have high levels of uric acid but don’t have any symptoms. These people are said to have hyperuricemia. Although it’s a risk factor, it’s not always necessary that the person will have an attack of gout.

What should I do if I have an attack of gout?

  • Rest.
  • Drink plenty of water.
  • Apply warm water over the affected area.
  • Visit an orthopaedic surgeon nearby.
  • Avoid high protein diet and alcohol.

What are the risk factors?

Risk factors for an attack of gout are:

  • High protein diet containing purines.
  • Alcohol intake
  • Stress
  • Dehydration
  • Family history of gout
  • High levels of uric acid in blood
  • Beverages sweetened with fruit sugar (fructose)

My uric acid is normal, still I have gout like pain

In some people the serum uric acid levels might be normal during an attack of gout. This is due to the fact that most of the uric acid has already crystallized into the joint. It may also be due to some other type of arthritis. Your doctor can usually differentiate between the different arthritis but sometimes it’s difficult and requires additional tests.

Deposition of calcium pyrophosphate can have similar symptoms as gout. This is condition called pseudo gout. Serum uric acid is normal in this case.

Is there a permanent cure for gout?

There is no permanent cure for gout. There are medicines which help to lower the uric acid levels and help to prevent gout attacks.

Treatment of Gout

Gout is treated with :

  • Diet control
  • Uric acid lowering medicines
  • NSAIDs

Food items to avoid in Gout

Gout is treated with :

  • Alcohol
  • Sea food
  • Red meat,
  • Organ meat (liver, kidney)
  • fish, poultry
  • Spinach
  • High-fructose corn syrup (HCFS)
  • soya bean