Gout any tissues in which MSU is deposited. Stages

Gout is an
inflammatory arthritis that develops in people who have high levels of uric
acid in their blood. The acid can form needle-like crystal in a joint and cause
sudden severe episodes of pain, tenderness, redness, warmth and swelling. It is
most commonly seen in men aged more than 75 years old.

Gout will
be manifested as hyperuricemia (serum uric acid > 7.8mg/dL) in initial
stage. Monosodium urate crystal (MSU) will then deposit in the joints and soft
tissues. This may be happened due to excessive uric acid production or kidney
cannot excrete uric acid from the body well enough. Inflammation can occur at
any tissues in which MSU is deposited.

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Stages of
Gout

Initially, self-limited
acute phase which characterized by recurrent attacks of synovitis (inflammation
of synovial membrane) will occur followed by chronic phase in which
inflammatory and structural changes of the joints and periarticular tissues may
lead to persistent symptoms. Although episodes of ACUTE gout rarely extend
beyond one week, they are usually associated with various degrees of functional
impairment. In the CHRONIC phase, the episodes of synovitis increase in number
and extends to several joints, being associated with persistent join pain,
swelling, tophi development and increasing comorbidity.

Periarticular
tissue: Tissue surrounding a joint

Synovitis:
Inflammation od synovial membrane

Source: http://www.medicalook.com/Joint_pain/Synovitis.html

Tophi
(plural of tophus): deposits of uric acid crystal

Source: http://www.footfiles.com/subject/tophus-tophi

Acute Gout

Acute gout,
also known as gout flare, usually has rapid onset and waking patient from
sleep, reaching a peak in 24-48 hours. The pain is terrible and often patient
can’t take care of themselves during the flares. The affected joints usually
become red, shiny and tender in a few hours after the first appearance of
symptoms Most commonly affected joints is the big toe, followed by foot, ankle,
knee, wrist, finger and elbow. More than half of the patient who have untreated
gout and hyperuricemia develops gouty tophi. Acute gout responsible for the
decrease in quality of life among patient. Deposition of uric acid crystal may
continue for months or years without causing any symptoms until shedding of
crystal into the synovial fluid.

Synovial
fluid: A fluid acts to reduce the friction of synovial joint during movement

Source: http://ostenil.trbchemedica.co.uk/patient-information/synovial-joint

Risk
factors of Gout

·        
Medical
condition (Obesity, high blood pressure, high levels of lipid, reduced kidney
function)

·        
Gender
(Men usually has a higher risk)

·        
Diet
(excessive consumption of sugary drink and alcohol)

·        
Family
history (First-degree relatives has a higher risk)

·        
Food
(Food high in purine: anchovies, mushrooms, peas, beans, kidney, liver, heart,
brain, gravies and others)

 

Lifestyle advice for people with gout

·        
Maintain
an ideal weight (BMI can be calculated here (http://www.calculator.com.my/bmi-calculator#.WmvnSWmuzZ4)

·        
Consume
low fat dairy, soy, vegetables sources of protein and foods rich in vitamin C

·        
Drink
water > 2 liter per day

·        
Avoid
dehydration

·        
Exercise
moderately

·        
Avoid
intense exercise and join trauma