Gout

Gout (also known as podagra when it involves the big toe) is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint.

The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected (approximately 50% of cases). It may also present as tophi, kidney stones, or urate nephropathy. It is caused by elevated levels of uric acid in the blood. The uric acid crystallizes, and the crystals deposit in joints, tendons, and surrounding tissues.

Symptoms of Gout :

Symptoms of gout include

  • Warmth, pain, swelling, and extreme tenderness in a joint, usually a big toe joint. This symptom is called podagra. The pain often starts during the night. It may get worse quickly, last for hours, and be so intense that even light pressure from a sheet is intolerable.
  • Very red or purplish skin around the affected joint. The joint may appear to be infected.
  • Limited movement in the affected joint.
  • Peeling and itching of the skin around the affected joint as the gout gets better.

Cause of Gout

  • The crystallization of uric acid, often related to relatively high levels in the blood, is the underlying cause of gout. This can occur for a number of reasons, including diet, genetic predisposition, or underexcretion of urate, the salts of uric acid.
  • Underexcretion of uric acid by the kidney is the primary cause of hyperuricemia in about 90% of cases, while overproduction is the cause in less than 10%. About 10% of people with hyperuricemia develop gout at some point in their lifetimes.
  • The risk, however, varies depending on the degree of hyperuricemia. When levels are between 415 and 530 μmol/l (7 and 8.9 mg/dl), the risk is 0.5% per year, while in those with a level greater than 535 μmol/l (9 mg/dL), the risk is 4.5% per year.
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