Gout is an illness caused by urate crystals deposition, overproduction of uric acid and the body’s inability to get rid of it. Gout diagnosis is made by distinguishing the urate crystal deposits in the different areas of the body.
Detecting gout in its earliest stage and providing the right treatments will help improve the condition greatly. This is evident in the decline of the number of people that have developed the crippling chronic tophaceous gout.
A gout patient may acquire tophaceous gout due to misdiagnosis, non-compliant of doctor’s advice, and an antagonistic attitude towards medication.
Patients with gout have been known to suffer excruciating pain. A considerable morbidity is also present in some gout cases. Acute gout attacks can result to incapacitation. Chronic tophaceous gout especially, if left untreated, can cause severe damage to the joints.
The presence of monosodium urate in the kidney can cause swelling and fibrosis. In the earliest stage of gout, one or two joints are usually affected. The attacks can be sudden, usually lasting up to 12 hours.
The joints acquire a reddish colour, hotness, and become very tender that you cannot even put a light sheet over it. Initial attacks sometimes go away even without treatment.
Gout diagnosis needs to be conclusive, especially for patients that require lifelong treatment. With a precise diagnosis, your physician can give the proper medication and treatment. Gout symptoms like an inflamed toe can be associated with other kinds of diseases so your doctor must be positive in declaring that your case is that of gouty arthritis.
Typically, the diagnosis is done by recognizing the uric acid crystals in the synovial fluid or in a large deposit of uric acid. It is detected by dripping a tiny amount of fluid on a slide and analysing it through a polarizing microscope. This process identifies the uric acid crystals by the way it bends light.
If a non-rheumatologist is the one checking your condition, he can perform the removal of the fluid from your joint and take the fluid to the lab for examination. Gout crystals are shaped like needles and have a yellowish or bluish tinge, depending on their position on the slide.
If crystal identification is not possible, other forms of diagnosis are required. Gout has specific features that distinguish it from other kinds of inflammatory arthritis. One distinctive characteristic of gout inflammation is that within 24 hours, the inflammation reaches its highest level while other types of arthritis develop at a slower pace.
The reddened joints, the appearance of the bunion joint, and the apparent high level of uric acid in the blood are also indications of gouty arthritis.
After a diagnosis has been confirmed, the patient must be assessed for gout complications. An evaluation is needed to locate large deposits of uric acid and tophi, which could appear anywhere in the body.
It is also important to determine whether the patient has a history of kidney stone since the combination of gout and kidney stone requires a more aggressive treatment to lower the uric acid level. This is to keep the stone formation from reappearing. A gout patient is also prone to acquiring coronary disease and must undergo a medical examination to check his cholesterol and triglyceride level.
X-rays, MRI, and ultrasound can show the developments of gout in the affected joints. If gout has already caused bone damage, it must be diagnosed right away since this could mean a long-term therapy is needed.
It Gets Complicated!
In the case of bone damage, it is vital that the total amount of the body’s uric acid level is reduced or removed from the affected area by equilibration. The blood level must be reduced in order to reduce the uric acid level in the joints.
Gout attacks will then slowly fade out and tophi will contract and eventually disappear. There are different types of medications which can be used to lower the total amount of uric acid in the body. For instance, the drug allopurinol is administered to slow down the production of uric acid.
Probenecid is also taken to escalate the disposal of uric acid from the body. Uric crystals can be interrupted through the use of Rasburicase and pegylated uricase.
To see the condition of gout in the joints, X-rays are usually used. But in cases where gout needs to be distinguished from a possible infection or tumour, MRI or ultrasound is usually required.
The combination of inflammation and pain in the joints clearly establishes the presence of gouty arthritis. Identifying it and the occurrence of tophi in the early stage of the disease helps considerably in the treatment process.
Thorough examination must be made so that a clear case of gout is established. This is because other types of arthritis that are diagnosed through the presence of uric crystals exhibit the same symptoms as gout.
Correct gout diagnosis is important so that the right treatment is determined immediately.