Gout

What’s gout?

Gout is a common and complex form of arthritis that can affect anyone. It’s present when there is too much uric acid in the blood. It’s characterized by a sudden severe attack of pain, swelling, and redness usually in the great toe joint. Other areas in the foot it can be found are the ankle joint, Achilles tendon, or midfoot.  Most of my patients affected by gout are present on Monday morning after a weekend of excess eating and drinking. The pain is so intense that it hurts when a bedsheet touches their feet.

What are the causes?

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

How do you diagnose it?

Gout can be 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. An 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.

How do you treat gout?

Treatment is based on the severity of the attack. It can range from NSAIDs, Colchicine, Medrol dose pack to Cortisone injection, which usually relieves the pain. It’s important to see a foot and 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.