Gout

Definition:

Gout is a form of arthritis which is caused by the accumulation of uric acid crystals in joints. In this condition, due to a metabolic dysfunction, there is deposition of uric acid in and around the joints causing severe painfulness, swelling and restricted mobility of the affected joint. 

Gout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints. When crystals form in the joints, it causes recurring attacks of joint inflammation arthritis. Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, andGout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history. It is often related to an inherited abnormality in the body's ability to process uric acid.

Symptoms:
Gout is an intensely painful condition, which mostly affects only one joint (monoarthritis) at a time, most commonly the big toe. However, Gout may also affect elbows, knees, ankles, wrists or small joints of the hands and feet. The classic history in a patient suffering from Gout is of excruciating and sudden pain, swelling, redness, warmth and stiffness of the joint. Low-grade fever may also be present. The skin overlying the joint can also be swollen, tender and sore if it is touched even lightly. Patients with longstanding hyperuricemia (high levels of uric acid in blood) can have uric acid crystal deposits called tophi in other tissues as well, e.g. the helix of the ear.

Causes of Gout:

Hereditary

Improper function of kidney which results in decreased excretion of urates in urine.

Reaction to alcohol. Reaction to certain drugs, including antibiotics.

Enzyme deficiencies.

Lead poisoning.

Disorder is often associated with an injury or surgical procedure.

Highly proteinous diet.

Unidentified causes—Idiopathic causes.

Starvation—diminished renal excretion of uric acid.

Psoriasis—due to over production of uric acid.

Toxaemia of pregnancy—due to diminished excretion of uric acid. May also occur in some cases of tumors or cancers.

Gout has four distinct stages     

 Asymptomatic: High levels of Uric acid in blood but no joint complaints

Acute phase: Acute complaints described above occur for a brief period

Intercritical phase: There is no pain or swelling of joints in this phase, the patient is relatively symptom-free.

Chronic: Gout attacks may become frequent during this phase and the condition may affect many joints at a time (polyarticular). Tophi formation may also be seen.