MEDICAL INSIDER
DR. CORA LIM
FOR AUGUST 13, 2023
GOUT
(Part 1)
We will start with a new topic today. It is all about Gout.
What is Gout?
Gout is a disease that is caused by too much uric acid, or urate,
in the body.
And how is Urate produced? Urate is produced by the
breakdown of chemicals called purines in the body, most of
which are made naturally by our body but some come from our
diet.
People with gout often have kidneys that are unable to flush out
extra urate through the urine, and when it builds up above a
critical level, it can form crystals of sodium urate.
What causes an attack of Gout?
As the urate crystals escape from the cartilage, these will
trigger sudden painful inflammation of the joint lining. Several
factors can affect the level of urate in your body. Some of these
are: Inherited conditions; the size of the body (the bigger the
body, the more urate is produced each day); metabolic
syndrome (high cholesterol in your blood, high blood pressure
or late-onset diabetes); kidney disease; and some tablets such
as diuretics
What are symptoms of an attack of Gout?
Some of the symptoms of an attack of Gout would include the
following: extreme pain that comes on quickly in the affected
joint (often the big toe); affected joints feeling hot and very
tender to the touch; affected joints looking swollen with the
overlaying skin often shiny and red.
Let us remember that Gout can cause long-term severe and
irreversible joint damage.
One has to seek the help from a Rheumatologist if he/she has
the symptoms indicate.
The diagnosis of the Rheumatologist is often based on your
symptoms and an examination of the affected joints.
What may a doctor suggest if a person has a Gout attack?
If a person has a Gout attack, the doctor may suggest a
blood test which can measure the amount of urate in your
blood which should be less than 360 μmo/L (equivalent to
6 mg/dl). Not everyone with a raised level of urate will
develop crystals in their joints. It is possible for urate levels
in the blood to be normal at the time of an acute attack
X-rays of joints may also be suggested by the doctor..
These x-rays will reveal joint damage in long-standing and
poorly controlled gout.
Ultrasound of joints can also be used to detect earlier
signs of gout.
Another suggestion could be Synovial fluid examinations
which would involve taking fluid samples from a joint
through a needle and examining them under a
microscope. (To be continued)