With gout, a type of arthritis, tiny mineral, or urate, crystals collect in certain joints, causing an intense inflammatory reaction. The crystals are composed of uric acid, a metabolic waste product normally excreted in the urine. In people with a hereditary metabolic defect, uric acid builds up in the blood and other body fluids. Most people with this condition, called hyper uricemia, do not develop gout, but those who do experience recurring attacks in the affected Joints and may also suffer kidney stones. Gout is primarily a male disease, and the big toe is its most common site, although it may affect other foot joints as well as the fingers, ankles, elbows, wrists, and knees. During an attack, the joint becomes painful, red, swollen, and hot to the touch. Attacks come on suddenly but pass quickly. The intervals between vary from a few days to years. When gout goes untreated, attacks become increasingly frequent and eventually damage the affected joints and sometimes the kidneys and other internal organs. In addition, deposits of urate crystals, called tophi, may occur under the skin near affected joints, over the elbow, or on the outside edge of the ear. These may eventually break through the skin and become infected.
Other Causes of Joint Pain
Pseudo gout is quite similar to gout, except the attacks are usually less severe and the crystals are composed of calcium pyrophosphate dihydrate. Joint pain may come from another form of arthritis, such as osteoarthritis, rheumatoid arthritis, or lupus. Bunions and other foot disorders produce pain and toe deformity.
Diagnostic Studies And Procedures
A doctor can usually diagnose gout on the basis of the symptoms and the appearance of the afflicted joint. A definitive diagnosis can be established by examining a sample of the joint fluid under a microscope with polarizing lenses. During an acute attack of gout, the uricacid crystals can be seen in the fluid, surrounded by white cells summoned by the immune system.