Gout symptoms, gout diagnosis and its untreated development.What are gout symptoms? How do you know you’ve really got gout and not another form of arthritis, or pseudo gout, or a fatty liver which can cause joint pain, or something else? Early symptoms.You may notice that something is not quite right in a joint (especially the joint of the big toe, either foot). It could be a little numb, and/or there might be a slight prickling sensation. These are early gout symptoms. What are flare ups like? A gout flare up is painful, inflamed, very sore, reddish and shiny. It often happens between midnight and 5am, and these gout symptoms occur quickly. The attack itself hasn’t built up over time, although the underlying condition almost certainly has. You may have a fever, a chill and a loss of appetite. End of the attack If untreated these gout symptoms will peak after one or two days and retreat after five days to a week. All this is telling you that gout is likely. GOUT DIAGNOSIS Age and Sex Well the first question is, are you over 40 and male or female? Although children can get gout (this is rare), gout usually occurs after the age of 40, and in men much more than women. Some say that before the female menopause men are as much as 20 times more likely to catch gout than women. But after the female menopause gout occurs almost equally between the two sexes. If you’re under 60 gout usually first attacks the joint of a big toe that connects to the foot bone, or one single joint elsewhere. If you’re over 60 it usually starts in the fingers or other joints. Tests Before five days have passed you should have had a couple of tests because you need to act immediately and know whether the gout symptoms really are gout or not. Initially, a uric acid test to discover your uric acid level. It may show uric acid levels above 7mg/DL(men)or 6.5mg/DL(women). But the results will probably not be accurate since during a gout attack, blood uric acid levels fall because more uric acid is excreted. Therefore the test will be repeated after the attack and the results most likely will be more accurate. The second test is a joint aspiration test, also called arthrocentesis. What happens here is that a sample of synovial fluid (the fluid between the joints) is taken from the gout attack site. An examination under an illuminated microscope reveals whether there are MSU gout crystals or not. The crystals are not rounded but needle shaped but you won’t see them with your naked eye.
LONG TERM GOUT'S DEVELOPMENT How does untreated gout develop? What is likely to happen? Gout flare ups can disappear for over a year. Or they could happen again in a matter of days or weeks. Over time, attacks become more frequent, and more painful to the point where a sufferer has daily pain. Gout affected joints may cease to work. Tophi develop. These are the irregularly shaped lumps of growing MSU gout crystals which develop at the initial attack site and later in other parts of the body such as fingers and wrists. And even in unusual spots unrelated to joints such as the ears’ ridges, and around the heart and spine. These latter three locations are not common. This is called tophaceous gout. New crystals develop in joints with existing crystals or in previously crystal free joints. Eventually, maybe 10 or 20 years after the first attack, the joints are destroyed and there is permanent pain. If treated it is highly unlikely the disease will reach this level. But if any reader really suspects gout symptoms or has had a gout attack, and hasn’t yet seen a doctor, this is your wake up call! And if you haven’t yet had a gout attack, but think you might this is your wake up call too, before your big toe calls on you. Sorry to put it so bluntly.
How gout is seen - A view from the pastThis is probably gout's most famous image, by the British cartoonist James Gillray in 1799. Gillray has draw gout as a Little Devil. It prowls a swollen foot, and has struck above the joint of the big toe.In the 18th century gout and scurvy assumed an importance and fear in the collective mind that cancer, heart disease and diabetes do to-day.
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