Symptoms of Gout.

Gout develops due to excess of uric acid in the blood. As explained in causes of gout, crystals of monosodium urate (uric acid derivative) get deposited in the joints  which give rise to gout symptoms. The symptoms of gout are typical and more severe at night.

The metatarsal joint at the base of the big toe is most commonly affected and accounts for 50% of all joints affected by gout. When gout involves the big toe, it is called Podagra. The other joints that may be affected are those of the feet, ankles, knees, wrists, fingers and elbows. The arthritis of gout is also called gouty arthritis.

Symptoms and Signs of Gout.

1) Gout Pain.

• The patient complains of severe pain in the affected joint.
• The pain of gout is more severe during the night and awakens the patient from sleep. Even the slight pressure from a bed sheet causes severe pain
• In acute attacks of gout, the pain has  a sudden onset.
• The gout pain may subside in a few hours or a few days. It is not uncommon to see gouty arthritis attacks last for a few weeks.

2) On examination of the affected joint (usually the joint of the big toe), it is found that the joint is warm to touch, it is extremely tender (tender meaning painful to touch or pressure) and swollen.

3) The skin on the joint becomes red or purplish.

4) There may be fever.

5) The movements of the affected joint are restricted.

6) Initially one or two joints may be affected but over time more joints can be affected.

7) Many gout patients develop chronic gout, where they get repeated attacks over a period of years. However, the subsequent attacks may not be very painful. About 60% of gout patients develop another gout attack within one year. However, some patients experience only one gouty arthritis attack in their life time.

As the gout attack subsides, the skin on the joint begins to peel off and there may be associated itching.

9) In chronic gout, nodules of uric acid crystals, called tophi, may be seen deposited in the soft tissues over the fingers, elbow tips, in the ears and around the big toe. However they may also appear on other parts of the body. Appearance of tophi signifies a substantially high uric acid level in the blood.

 

 

Pictures of Tophi.

 

 

 

10) Rarely, when the urate crystals get deposited in the bursa of a joint, it causes bursitis. Bursa is the sac in the joint which contains a fluid which acts as a cushion between the two bones in a joint.

Picture of normal and gout foot.

Other medical conditions which have symptoms resembling gout.

The symptoms of gout such as pain, swelling, hot and tenderness may also be seen with the following conditions.

• Rheumatoid arthritis. The difference here is that RA affects more than one joint and can affect joints of both hands or feet while gout usually attacks one joint and usually of the feet.
• Osteoarthritis. Osteoarthritis develops slowly, usually affects one joint and the big joints such as the hip joint and the knee joint.
• Pyrogenic ( bacterial) infection of a joint can also present with symptoms similar to those of gout.

 

Related posts:

1. Gout.
2. Diagnosis of Gout.
3. Causes of Gout.
4. Complications of Gout.
5. Treatment of Gout.
6. Diets for Gout.
7. Osteoarthritis-Causes, Symptoms, Treatment.
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