DR. CORA LIM
MEDICAL INSIDER
Gouty Arthritis
(Part 1)
We start discussing a new topic today – GOUTY
ARTHRITIS.
Gout is an inflammatory arthritis which is the most
common type. This is the reason for the sudden and
intense attacks of joint pain, often in the big toe and
happens at night.
It can also happen to other toes or the ankle or knee. In
some cases especially for people with osteoarthritis, the
gout attack may be experienced in their finger joints.
Gouty Arthritis may be precipitated by local trauma
unaccustomed exercise & alcohol consumption. It could
also be felt through an excruciating pain over hours
frequently in the evening.
The clinical presentation of Gouty Arthritis may be in the
following conditions: swelling, redness & tenderness,
monoarticular & lower extremities and may affect the
knees, wrist, elbows & rarely SI & hips
What are the Stages of Gouty Arthritis?
Gouty Arthritis may progress through four clinical stages
which are: asymptomatic hyperuricemia, acute gouty
arthritis, intercritical gout (intervals between acute
attacks) and chronic tophaceous gout.
Asymptomatice Hyperuricemia – this is the stage
with abnormal high serum urate level, without gouty
arthritis or mephrolithiasis
Acute Gouty Arthritis – this stage is characterized
by the sudden onset of pain, erythema, limited
range of motion and swelling of the involved joint
Intercritical Gout – this is the asymptomatic phase
or intervals between attacks of gouty arthritis. A
patient who has intercritical gout simply has gout
that has caused attacks of inflammation in a joint in
the past, but it is not visibly active at the time the
doctor is evaluating the said patient.
Chronic tophaceious gout – this stage is
characterized by attacks that are frequent and
deposits of tophi (uric crystals) begin to collect
under the skin. (To be continued)