What’s gout?

Gout is a common and complex form of arthritis that can affect anyone and is present when there is too much uric acid in the blood . It’s characterized by a sudden, severe attacks of pain swelling and redness usually in the great toe joint. Other area in the foot it can present are the ankle joint, achilles tendon or the mid foot.  Most of my patients affected by gout present to the office on a Monday morning after a weekend of excess eating and drinking.  The pain is so intense that a bed sheet can’t even touch their foot.

What are the causes?

Caused initially by an excess of uric acid crystals in the joint, causing inflammation and intense pain. Uric acid is produced in the body during the breakdown of purines chemical compounds that are found in the high amounts of certain foods such as meat poultry and seafood.

How do you diagnose it?

Gout is ultimately diagnosed with a combination of clinical exam, blood work and x-ray. Uric acid tests can be ordered at the time of an acute gout attack to see the levels. X-ray can be used to see if there’s any generation of the joint, which is commonly called in Martell sign. Sometimes, we aspirate the joint to test the fluids for crystals.

What’s the treatment of gout?

Treatment is based on the severity of the attack. It can range from NSAID S, Colchicine, Medrol dose pack or Cortisone injection into the joint which usually resolves the pain the fastest. It’s important to see your Foot & Ankle specialist to help determine the best treatment for your foot. Sometimes, patients are placed on medications to help prevent future attacks.  When attacks happen several times in a year, the patient will sometimes be placed on Allopurinol.