Gout arthrosis

According to statistics, gouty arthrosis affects men of 40 years of age and women no younger than 60 years old. The peculiarity of the development of the disease in increasing uric acid levels. Gradually, this metabolic product accumulates in the joints, which provokes the inflammatory process, and is the main sign of gout. The arthritic form of the disease is acute in contrast to arthrosis diagnosed in the chronic course of the disease.

Causes and mechanism of development

Gouty arthritis has long been considered a disease of kings and nobles, as it affected mainly people of the upper class.

Gout can occur for a long period without vivid clinical manifestations. The main causes of pathology:

  • excessive consumption of meat dishes and rich broths, alcoholic beverages;
  • s >The disease develops with an increase in uric acid levels.

As a result of exposure to negative factors in the blood, the concentration of uric acid increases. Urate crystals accumulate in the cartilage of the joints and lead to disruption of the articulation. Because of this, inflammation develops, stimulating the pathological proliferation of tissues, osteoarthritis may occur. Gouty arthritis can occur in a latent form for a long time. With exacerbation of gout, severe inflammation of the toes and joints on the hands occurs.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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What can trigger an attack?

Chronic arthrosis against the background of gout appears periodically, depending on the negative conditions present. Risk factors include:

  • Stress. With nervous tension, hundreds of thousands of cells die, causing a large volume of uric acid to enter the bloodstream.
  • Binge eating. The abuse of fatty meat dishes and wine is dangerous for people with gout.
  • Dehydration. Gout arthrosis is clearly manifested after the uncontrolled use of diuretics.
  • Infectious lesion. The penetration into the body of streptococci negatively affects the general condition. An exacerbation of the disease may be associated with transferred sore throat or tonsillitis.
  • Hypothermia. Arthrosis of the foot may worsen after a person freezes, or soaks his feet.
  • Injuries. Chronic joint damage is clearly manifested after trauma to the patient articulation. Especially often for this reason, inflammation develops on the fingers and toes.
  • Physical exercise. The use of uncomfortable shoes, sports, long walks lead to exacerbation of arthrosis.

Gouty inflammation in the joints is considered a male disease. In women, the pathology is diagnosed much less frequently, and the disease is easier for women than men.

Main symptoms

Gouty foot arthritis appears periodically. The frequency of occurrence of symptoms varies from once a week to 2 seizures per year. Symptoms of an acute period:

  • the development of inflammation is asymmetric, which makes it possible to distinguish rheumatoid arthritis;
  • the occurrence of severe pain in the affected joint;
  • decreased joint mobility;
  • hyperemia of the skin over the affected area;
  • exacerbation of pain during movement;
  • general increase in temperature.

Complicated by a purulent process, arthritis has similar symptoms, which allows you to diagnose the disease at the initial stage of development. Usually the pathology affects the big toes, but there are cases when the joints of the hands suffer. In the absence of treatment, the cartilage tissue is gradually destroyed, and the resulting voids are filled with deposits of uric acid. This can provoke a complete loss of joint mobility and disability.

Diagnosis of gouty arthrosis

With existing inflammation of the joint, an X-ray examination is performed. The resulting image shows the condition of the bones, the presence of purulent formations and changes in cartilage. If gouty arthritis is suspected, the main diagnostic method is sampling and analysis of synovial fluid. If the study indicates a high concentration in the periarticular space of uric acid, this indicates the gouty nature of arthrosis. High levels of purine substances in the blood and inflammation of the joints cannot be considered as the main symptom of gouty arthrosis.

What treatment is used?

It is impossible to eliminate the pathology at home without the necessary doctor’s prescriptions. Even if a person succeeds in removing inflammation with the help of folk remedies, the pathology will turn into a chronic form, and will certainly appear again. The difference between self-medication and the help of a qualified professional is obvious. It is necessary to treat arthrosis in a comprehensive manner, first of all, the diet and body weight should be adjusted.

Medications

Treatment of gouty arthritis with medication is aimed at eliminating inflammation and reducing the concentration of purines in the blood. The use of NSAIDs and warming anti-inflammatory ointments is recommended. The patient must take the specific remedies prescribed for gout. These include:

  • Allopurinol. Reduces uric acid production.
  • “Probenecid.” It stimulates the elimination of harmful substances from the body, cleans joints of salt deposits.
  • “Urikozim.” Destroys the formed salt crystals.

Folk remedies

To remove inflammation and ease the general condition of a person, recipes of traditional medicine allow, but they can not replace drug therapy. With an exacerbation of pathology, the following agents are used:

  • compresses with cabbage leaves;
  • honey applications;
  • iodine salt baths.

Properly selected therapy quickly relieves a person of the signs of the disease, but you can not stop at the achieved result and arbitrarily stop treatment. Otherwise, the disease will recur.

Necessary diet

Since gouty arthritis and osteoarthritis occurs in most cases due to nutritional errors, it is important for the patient to adjust the diet. If you do not change your gastronomic habits, drug therapy will not give the necessary result. Table 6 is prescribed for patients with gouty arthrosis, which excludes foods rich in purine substances from the diet.

Diet involves the rejection of fatty dishes from meat, poultry and fish, rich broths. Seafood, canned goods and smoked meats are banned. Non-fat dairy products, cereals, vegetables and fruits are allowed. You need to drink at least 2 liters of water without gas daily. This helps to reduce the concentration of harmful substances in the blood and cleanse the body.

Gout is arthritis or arthrosis: differences and similarities.

How gout is clinically manifested: is it arthritis or arthrosis, why they are compared, what do they have in common and how does gouty arthritis differ from other joint diseases. After reading this article, you can find the answers to these questions and understand the terminology to finally understand in what cases a particular diagnosis is made, and how everything is determined from a medical point of view.

What unites these diseases

To understand, gout is arthritis or arthrosis, how rheumatoid arthritis differs from gout, or what gout and rheumatism have in common, first you need to understand how the recognition, definition of the disease occurs, as evidenced by the medical diagnosis.

In order to systematize the data, the World Health Organization has developed a system for classifying diseases and health problems. For convenience and standardization of the diagnosis, an alphanumeric encoding is introduced. This classification (reference) allows you to establish certain requirements for the provision of medical care in relation to a specific group of diseases (treatment regimen, duration of therapy), analyze the level of mortality, severity and susceptibility to treatment, and calculate the prevalence (frequency of occurrence).

According to the adopted structure of the ICD-10, all painful conditions are grouped by unifying signs, in particular by anatomical localization. In accordance with the principles of classification, the listed diseases are assigned to the XIII class and are located under the Latin letter M. This group covers diseases that affect the bones, muscle system, joint-ligamentous apparatus, and connective tissue. Depending on the origin of the pathology, its signs and development mechanism, the class is divided into blocks, including diseases that have common characteristics.

  1. Arthropathies are joint lesions of a non-rheumatic origin. Usually they arise against a background of a different pathology, and the symptoms of arthropathy directly depend on the type of this underlying disease. Within this block, infectious diseases (tuberculous arthritis, arthritis with rubella or mycosis, dysentery, purulent / pyogenic arthritis, etc.), inflammatory with damage to many joints (rheumatoid arthritis, juvenile, gout), degenerative-dystrophic in nature ( various types of arthrosis).
  2. Diseases of the soft periarticular tissues are extra-articular diseases. This subgroup also includes extra-articular rheumatism, rheumatism of the skin, subcutaneous tissue.
  3. Diffuse diseases of the connective tissue are diseases that stimulate systemic disorders and inflammation. Various organs and systems of the body are affected. These are: rheumatic polymyalgia, eosinophilic fasciitis, lupus erythematosus, arthropathy with hemophilia or neoplasms.
  4. Dorsopathies are diseases affecting the structures of the spine and surrounding tissues (scoliosis, osteochondrosis, torticollis, ankylosing spondylitis).
  5. Varieties of chondropathy and conditions in which the processes of formation, growth, functioning or restoration of bone tissue (osteoporosis, osteomyelitis, pathological fractures, poor fusion) are disturbed.

All of these diseases have one thing in common – the presence of problems with the musculoskeletal system. Often they have the same symptoms: the absence of external manifestations at first, pain of varying intensity and localization, a change in the shape of the joint, stiffness, stiffness, limitation of walking distance.

These signs of similarity serve as the basis for combining together, but it is impossible to say, for example, that arthrosis, rheumatism and gout are the same thing. No wonder these forms of the disease are indicated by various medical terms, because each is characterized by a number of inherent properties and the presence of disconnecting signs.

Distinctive features of gout

According to statistics, the most common forms of joint damage are arthritis and arthrosis, gout is detected much less frequently. Finding the difference between arthritis and gout can be problematic, often they have the same symptoms and scenario.

    hyperemia of the skin over the affected area, accompanied by redness, sensations of heat at the local level; swelling of the foot; pain on palpation; impaired limb function, temporary blockage of the joint.

Arthrosis is not an inflammatory process. These are degenerative-dystrophic changes in the affected joint, the cause of which is the destruction of the cartilage that covers the articular ends of the bones. Arthrosis is always associated with bone deformation, because its second name is deforming osteoarthrosis. When wondering how to distinguish arthrosis from other diseases by external signs, you should pay attention to the difference in the type of pain.

Unlike gouty arthritis, pain with arthrosis is mechanical in nature, at the initial stage it occurs only periodically, in the evening after a hard day or at night, often due to physical overload. During the night or after a long rest, the pain decreases or disappears. In the case of gout, it is always an unbearable, suddenly appearing shooting pain, usually overtakes during sleep. A gouty attack can last from several hours to a week, and after several months the attack is repeated.

The saying that gout and arthritis are one and the same can only be true for this type of disease. This postulate is simply explained: recurrent acute arthritis is a clinical manifestation of gout. He is considered one of the stages of the course of the disease and the first external sign. The difference between gout and arthritis and rheumatism is that the name gout is usually applicable to the monoarticular (mono-articular) and unilateral process, and only the joints of the toes are affected.

However, you should be aware that when gout passes into the chronic stage, a tendency to spread is detected, a greater number of articular joints are involved in the pathological process. In such cases, gouty polyarthritis is diagnosed. In parallel with its development, the destruction of hyaline cartilage occurs with the formation of defects in the bones. Such cavities are subsequently filled with urate crystals. Joint deformation occurs, functional activity is lost.

Rheumatoid Arthritis and Gout

Why are these completely different systemic diseases compared and how are uric acid and rheumatoid arthritis related. Comparison and search for the general is due to the similarity of symptoms. Both diseases are inflammatory, provoke pain, swelling, redness, skin tightness in the affected area. The symptoms are especially similar in the later stages, when treatment is not performed, and the examination reveals chronic gouty deposits in the joints that are difficult to distinguish from rheumatoid nodules.

The main difference between rheumatoid arthritis and gout is the causes of the development of inflammatory reactions. If in the first case the cause of the inflammatory process is a malfunction in the immune system, then with gout due to everything, there is a high level of uric acid in the blood. Studies show that in 5,3% of patients with RA, gout was diagnosed simultaneously. If the presence of both diseases is confirmed, correction of treatment regimens is required (a diet is prescribed, drugs that block the synthesis of uric acid or contribute to its removal).

In addition to gouty arthritis, there are several other clinical forms that are considered atypical:

    rheumatoid gout – is characterized by multiple, often symmetrical damage to the joints, spreading to the joints of the hands (wrist, interphalangeal, metacarpophalangeal joint). Due to the fact that such localization is more typical for a rheumatoid species, such gout was called rheumatoid; Senile rheumatic gout – occurs with damage to the proximal (upper) parts of the arms and legs in the absence of articular deformities. What is rheumatic gout? This is the name of the symptom complex, which reflects severe pain, stiffness of the muscles of the shoulder or pelvic girdle (or at the same time). The disease begins acutely, amid well-being, symptoms may gradually increase. This form occurs mainly in the elderly – after 50 years.

Gout or arthritis – how to determine

The occurrence, course and outcome of gout determines precisely the concentration of uric acid in the blood and urine. With an increase in its level in the body, the accumulation of uric acid compounds occurs, their deposition in various organs and tissues. Gradually, deposited in soft tissues, urate crystals form gouty tofus, which contribute to the onset of inflammation in the periarticular sacs and tendons.

What is the difference between arthritis and gout? Arthritis, as an independent joint disease, is slowly but steadily progressing. Preventive measures, therapeutic exercises and drug therapy can only alleviate the symptoms and slow down the rate of development of the disease, which ultimately leads to a decrease in the functionality of the joint.

Signs of gouty arthrosis and methods for its treatment

Gout is a disease associated with a malfunction in metabolic processes, due to which the uric acid level in the body rises and its salts accumulate. This entails functional impairment of the joints and kidneys. One of the complications of gout is gouty arthrosis, which in modern medicine has not only been thoroughly studied, but also learned to properly treat. This allows you to successfully cope with the disease and take up its prevention, so that in the future at every step you feel only ease in movement.

A few words about gout

The development of gout can occur in the body asymptomatically for a sufficiently long period of time until prolonged physical exertion, stress, hypothermia or alcohol abuse provoke the very first attack of the disease.

The disease is based on metabolic disorders, the causes of which are a variety of adverse factors. These include:

  • improper nutrition: excessive consumption of meat products, strong broths on meat, abuse of coffee, tea and alcohol;
  • taking medications from the group of diuretic, hypotensive, cytostatic and several others;
  • the presence of hormonal abnormalities and diseases of the k >

It should be noted that belonging to a strong male gender and overweight increase the chances of getting gout several times. Depending on all these factors, scientists conditionally divide gout into two main groups: primary – the result of a combination of heredity with malnutrition, secondary, which occurs with concomitant diseases along with medications.

Causes of Joint Damage

The development of inflammatory processes in the joints with gout is the result of the accumulation of uric acid crystals with their subsequent deposition in the articular structures. The crystals have an intense destructive effect on the hyaline cartilage of the joint, which gradually captures the joint tissue. Arthrosis develops with the appearance of periarticular tumors of a tumor-like nature.

Mostly small joints are affected, most often – thumbs on the lower extremities. Further in descending order go the ankle, knee joints, fingers, wrist and elbow joints. The age category susceptible to this pathology has a fairly large range: from 25 to 50 years.

Gouty arthrosis is characterized by a long course and constant relapses. In some cases, over time, gradual damage to almost all joints on the legs and arms is possible. Often the kidneys are involved in the pathological process with the formation of urate stones in them.

Medicine knows cases when the course of gout was quite severe and was accompanied by manifestations of severe intoxication, as well as destructive processes of a massive nature involving several large joints at once. Such situations are quite rare, but this does not mean that in other cases the disease proceeds easily.

The long course of the pathological process in any joint gradually leads to a violation of its functions. Gradually there is a greater likelihood of disability, especially in the absence of proper treatment.

Symptoms

Any pathological process in the body proceeds according to a certain scenario, which allows doctors, together with additional diagnostic procedures, to distinguish different diseases from each other and prescribe appropriate therapy.

In the development of gouty arthrosis, it is customary to distinguish three main periods:

    Latent. It is characterized by the absence of clinical symptoms, and the disease can be detected only with the help of laboratory tests for uric ac >

Gouty seizures occur from once per week to two times per year. Symptoms of exacerbations have quite characteristic signs:

  • joint damage on one side;
  • the occurrence of intense pain in the affected joint (mainly the big toe);
  • limitation of joint mobility;
  • redness of the skin over the area of ​​the affected joint;
  • pain intensifies with movements;
  • fever.

If you do not seek the help of a doctor in a timely manner and start the process, trying to cure the disease yourself, further manifestations of gouty arthrosis will develop. These include tofus – whitish growths, consisting of uric acid and joint tissue and located under the skin around the affected joint. Also, over time, in the area of ​​small joints of the arms and legs, successive pains of a periodic nature will arise.

important points

A number of signs of gouty arthrosis should be discussed separately, since they are of great importance. It is important that in 90% of all cases of the disease, the very first pathological process affects the big toe. It is at this stage that you should urgently seek help from a medical institution, where they will help to clarify the diagnosis and prescribe a course of treatment.

In cases where the disease proceeds with great intensity, the skin over the affected joint acquires a red tint, becomes hot and painful to the touch. The temperature rises. A prolonged course of the disease entails the formation of tofus and the gradual destruction of articular cartilage.

If you continue to ignore gout with its manifestations in the form of arthrosis, the bones in the area of ​​the affected joints will be involved in the process. In the absence of medical treatment, the appearance of the joint will take on an ugly outline, and its functionality will suffer up to disability.

Diagnostic procedures and treatment

The basis of all diagnostic procedures for gouty arthrosis is the detection of uric acid salts in synovial fluid taken from the affected joint. It is also allowed to conduct a study of fluid taken from any large joint that is not affected by the pathological process. The contents of tofus in some cases can also serve as a diagnosis.

It is worth noting the fact that an increase in the content of uric acid, coupled with a periodic inflammatory process that seizes the joint area of ​​the big toe, does not always serve as a sign of gouty arthrosis or gout. This is only evidence that there is a violation of purine metabolism (hyperuricemia) in the body.

The treatment process for the gouty type of arthrosis is carried out using the innovations of modern medicine and proven over the years folk methods, which together allows you to cope with the disease. But the very first step is a proper diet and a balanced diet. You should not eat meat products, liver and kidneys, sausages and jellies, fatty varieties of fish and smoked meats, abuse alcohol and eat a lot of chocolate.

The use of rye and wheat bread, cereals, eggs, natural dairy products, vegetable and butter, as well as a large number of fruits and vegetables will help consolidate the positive results of drug therapy or alternative treatment methods. It is also necessary to find out the main causes of the disease and try to eliminate them if possible.

The drug therapy for gouty arthritis will not differ from that for gout and includes:

    taking non-stero >

From the field of traditional medicine, chamomile baths with salt will help: for 100 grams of flowers, 30 grams of salt and 10 liters of hot water are required. Salt and chamomile need to be poured with water and insisted for an hour in a large container, then put in it a sore leg or arm and keep it there until the pain decreases. Repeat every day for a couple of weeks.

You should also try to lose extra pounds and try to reduce the load on the affected joint. With timely treatment, the symptoms of gout will respond well to therapy and will gradually disappear. But we should not rest on our laurels, because the disease will return again.

It is necessary to carefully follow a diet, not to load sore joints and try not to gain extra pounds. A diagnosis of gouty or any other arthrosis is not a sentence. You just need to tune in to the best, fight the disease together with your doctor, observe all its prescriptions and recommendations.

The internal mood plays a huge role not only in treatment, but also in the prevention of many diseases. Therefore, one must believe in one’s strengths and huge potential of one’s body. Then the disease will recede for many years, and freedom of movement will allow you to engage in daily affairs with a smile.

Gout is arthritis or arthrosis: differences and similarities.

How gout is clinically manifested: is it arthritis or arthrosis, why they are compared, what do they have in common and how does gouty arthritis differ from other joint diseases. After reading this article, you can find the answers to these questions and understand the terminology to finally understand in what cases a particular diagnosis is made, and how everything is determined from a medical point of view.

What unites these diseases

To understand, gout is arthritis or arthrosis, how rheumatoid arthritis differs from gout, or what gout and rheumatism have in common, first you need to understand how the recognition, definition of the disease occurs, as evidenced by the medical diagnosis.

In order to systematize the data, the World Health Organization has developed a system for classifying diseases and health problems. For convenience and standardization of the diagnosis, an alphanumeric encoding is introduced. This classification (reference) allows you to establish certain requirements for the provision of medical care in relation to a specific group of diseases (treatment regimen, duration of therapy), analyze the level of mortality, severity and susceptibility to treatment, and calculate the prevalence (frequency of occurrence).

According to the adopted structure of the ICD-10, all painful conditions are grouped by unifying signs, in particular by anatomical localization. In accordance with the principles of classification, the listed diseases are assigned to the XIII class and are located under the Latin letter M. This group covers diseases that affect the bones, muscle system, joint-ligamentous apparatus, and connective tissue. Depending on the origin of the pathology, its signs and development mechanism, the class is divided into blocks, including diseases that have common characteristics.

  1. Arthropathies are joint lesions of a non-rheumatic origin. Usually they arise against a background of a different pathology, and the symptoms of arthropathy directly depend on the type of this underlying disease. Within this block, infectious diseases (tuberculous arthritis, arthritis with rubella or mycosis, dysentery, purulent / pyogenic arthritis, etc.), inflammatory with damage to many joints (rheumatoid arthritis, juvenile, gout), degenerative-dystrophic in nature ( various types of arthrosis).
  2. Diseases of the soft periarticular tissues are extra-articular diseases. This subgroup also includes extra-articular rheumatism, rheumatism of the skin, subcutaneous tissue.
  3. Diffuse diseases of the connective tissue are diseases that stimulate systemic disorders and inflammation. Various organs and systems of the body are affected. These are: rheumatic polymyalgia, eosinophilic fasciitis, lupus erythematosus, arthropathy with hemophilia or neoplasms.
  4. Dorsopathies are diseases affecting the structures of the spine and surrounding tissues (scoliosis, osteochondrosis, torticollis, ankylosing spondylitis).
  5. Varieties of chondropathy and conditions in which the processes of formation, growth, functioning or restoration of bone tissue (osteoporosis, osteomyelitis, pathological fractures, poor fusion) are disturbed.

All of these diseases have one thing in common – the presence of problems with the musculoskeletal system. Often they have the same symptoms: the absence of external manifestations at first, pain of varying intensity and localization, a change in the shape of the joint, stiffness, stiffness, limitation of walking distance.

These signs of similarity serve as the basis for combining together, but it is impossible to say, for example, that arthrosis, rheumatism and gout are the same thing. No wonder these forms of the disease are indicated by various medical terms, because each is characterized by a number of inherent properties and the presence of disconnecting signs.

Distinctive features of gout

According to statistics, the most common forms of joint damage are arthritis and arthrosis, gout is detected much less frequently. Finding the difference between arthritis and gout can be problematic, often they have the same symptoms and scenario.

    hyperemia of the skin over the affected area, accompanied by redness, sensations of heat at the local level; swelling of the foot; pain on palpation; impaired limb function, temporary blockage of the joint.

Arthrosis is not an inflammatory process. These are degenerative-dystrophic changes in the affected joint, the cause of which is the destruction of the cartilage that covers the articular ends of the bones. Arthrosis is always associated with bone deformation, because its second name is deforming osteoarthrosis. When wondering how to distinguish arthrosis from other diseases by external signs, you should pay attention to the difference in the type of pain.

Unlike gouty arthritis, pain with arthrosis is mechanical in nature, at the initial stage it occurs only periodically, in the evening after a hard day or at night, often due to physical overload. During the night or after a long rest, the pain decreases or disappears. In the case of gout, it is always an unbearable, suddenly appearing shooting pain, usually overtakes during sleep. A gouty attack can last from several hours to a week, and after several months the attack is repeated.

The saying that gout and arthritis are one and the same can only be true for this type of disease. This postulate is simply explained: recurrent acute arthritis is a clinical manifestation of gout. He is considered one of the stages of the course of the disease and the first external sign. The difference between gout and arthritis and rheumatism is that the name gout is usually applicable to the monoarticular (mono-articular) and unilateral process, and only the joints of the toes are affected.

However, you should be aware that when gout passes into the chronic stage, a tendency to spread is detected, a greater number of articular joints are involved in the pathological process. In such cases, gouty polyarthritis is diagnosed. In parallel with its development, the destruction of hyaline cartilage occurs with the formation of defects in the bones. Such cavities are subsequently filled with urate crystals. Joint deformation occurs, functional activity is lost.

Rheumatoid Arthritis and Gout

Why are these completely different systemic diseases compared and how are uric acid and rheumatoid arthritis related. Comparison and search for the general is due to the similarity of symptoms. Both diseases are inflammatory, provoke pain, swelling, redness, skin tightness in the affected area. The symptoms are especially similar in the later stages, when treatment is not performed, and the examination reveals chronic gouty deposits in the joints that are difficult to distinguish from rheumatoid nodules.

The main difference between rheumatoid arthritis and gout is the causes of the development of inflammatory reactions. If in the first case the cause of the inflammatory process is a malfunction in the immune system, then with gout due to everything, there is a high level of uric acid in the blood. Studies show that in 5,3% of patients with RA, gout was diagnosed simultaneously. If the presence of both diseases is confirmed, correction of treatment regimens is required (a diet is prescribed, drugs that block the synthesis of uric acid or contribute to its removal).

In addition to gouty arthritis, there are several other clinical forms that are considered atypical:

    rheumatoid gout – is characterized by multiple, often symmetrical damage to the joints, spreading to the joints of the hands (wrist, interphalangeal, metacarpophalangeal joint). Due to the fact that such localization is more typical for a rheumatoid species, such gout was called rheumatoid; Senile rheumatic gout – occurs with damage to the proximal (upper) parts of the arms and legs in the absence of articular deformities. What is rheumatic gout? This is the name of the symptom complex, which reflects severe pain, stiffness of the muscles of the shoulder or pelvic girdle (or at the same time). The disease begins acutely, amid well-being, symptoms may gradually increase. This form occurs mainly in the elderly – after 50 years.

Gout or arthritis – how to determine

The occurrence, course and outcome of gout determines precisely the concentration of uric acid in the blood and urine. With an increase in its level in the body, the accumulation of uric acid compounds occurs, their deposition in various organs and tissues. Gradually, deposited in soft tissues, urate crystals form gouty tofus, which contribute to the onset of inflammation in the periarticular sacs and tendons.

What is the difference between arthritis and gout? Arthritis, as an independent joint disease, is slowly but steadily progressing. Preventive measures, therapeutic exercises and drug therapy can only alleviate the symptoms and slow down the rate of development of the disease, which ultimately leads to a decrease in the functionality of the joint.

Gout in men: signs, causes and treatment

Gout, known to mankind since ancient times, in its history has repeatedly undergone a change in the attitude of society. In ancient times, it was considered a “disease of vice”, in the era of enlightenment – “a disease of kings,” at the beginning of the th century – a “disease of geniuses.”

Having not lost its relevance over the centuries, this ailment continues to excite the stronger sex: “gout – what kind of disease do men have, what treatment?”, “What is gout on the legs of men?”, “What are the causes of gout on the legs of men?” , “What are the signs of gout on the legs of men?”, “What is the most effective treatment for gout on the legs of men?” Here are just a few of the questions with which patients come to the doctor.

In our article, we will talk about the causes of gout, its symptoms and treatment in men, since Hippocrates noted that this ailment does not affect young women and eunuchs. A similar “gender injustice” is associated with the fact that estrogens produced in the female body help to remove uric acid from the body, preventing it from accumulating in excess. Accordingly, the manifestations of gout in men who are not protected by these hormones are noted on average 9 times more often than in women.

Of course, the features of hormonal status are not the only cause of gout, but many factors can provoke this disease with the same frequency in both men and women. We will talk about them below.

What is gout in men

Gout is a metabolic disease in which, against the background of increased formation of uric acid or a decrease in its excretion, hyperuricemia (increased level of uric acid in the blood) occurs, followed by “sedimentation” of sodium monourate crystals (the so-called “salts”) in various body tissues (more often in periarticular structures and intraarticular fluid). Urate stones (stones) are also formed in the urinary organs (bladder, ureters, kidneys).

What causes gout in men

Hyperuricemia can lead to excessive intake of purine bases in the body, the decay product of which it is. And they come mainly with food: red varieties of meat and fish, coffee, cocoa and chocolate, cheeses, sausages, smoked meats, alcoholic beverages. Intemperance in the use of these products inevitably leads to the deposition of urate in the tissues. In ancient times, not everyone could afford the abuse of such products, therefore gout was called the “aristocratic disease”, because its presence testified to a certain level of well-being. The relationship between the development of gout, the severity of its symptoms and the volume of treatment in men with nutrition, or rather, its imbalance and irrationality, is obvious. With an increase in the standard of living of the population, the incidence of this disease has also increased – gout is truly a disaster for overeating humanity, while in third world countries it is quite rare.

On the other hand, the concentration of uric acid in the blood also increases with violations of its excretion in the urine. This happens with various pathologies of the kidneys and other conditions associated with the development of their function.

In the early stages, this metabolic imbalance does not manifest itself – a laboratory examination may reveal an increase in urinary concentration
blood acids or urate crystals in urine sediment, but there are no other symptoms of the disease.

Less commonly, hyperuricemia develops with tumor diseases, pathologically high physical exertion, sepsis (inflammation of the blood) – this is the so-called reactive gout.

How does gout manifest in men

The first signs of gout in men usually appear suddenly: against the background of relative well-being, often after errors in the diet and drinking alcohol an acute attack of gouty arthritis (inflammation of the joint) occurs. This arthritis is able to affect the shoulder, elbow, wrist and other joints, but the most characteristic first signs of gout appear on the legs – in men, as well as in women, the first metatarsophalangeal joint (big toe) and the joints of the foot are “attacked”. It is no coincidence that “gout” literally means “a foot in a trap” when translated. The symptoms of gout with inflammation of the joints on the legs of men are as follows: sharp, unbearable, burning pains in the joint suddenly occur (patients often call them “gnawing”), the joint increases sharply in size, blushes, swells, and movements in it become impossible. This is the so-called gouty attack. The process, as a rule, is one-sided.

When the acute symptoms of arthritis (while taking medication, physiotherapy or other folk remedies for treating gout) in men subside, the disease goes into the next phase – the interictal period. This is a period of relative prosperity in which a person may not be bothered by anything.

But if provocative factors are not excluded, the lifestyle is not changed, and the prevention of exacerbations is not carried out – a gouty attack will occur again. With a wavelike alternation of interictal periods and exacerbations, the disease becomes chronic tofus form. In this phase, in addition to the articular symptoms of gout, men develop tofus – deposits of urate salts. Tofus can be external, forming within the soft tissues, more often in the projection of the affected joints (look like whitish-yellow rounded dense plaques), and internal when salts are deposited directly in the joint cavity.

Other common signs of gout in men include secondary damage to the urinary organs: an increased content of urates in the urine leads to their deposition in the bladder, ureters, but most often in the renal pelvis in the form of urate stones. Urolithiasis develops, often accompanied by secondary inflammation of the affected kidney – pyelonephritis.

What is dangerous gout for men

The result of gout in men can often be disability, because with constantly recurring inflammation in the affected joint, irreversible changes form, secondary degenerative arthrosis develops, which ultimately leads to persistent movement disorders in it. Tofus also entail not only a cosmetic defect, but also serious complications: they can spontaneously open, suppurate, increasing the risk of purulent inflammation in a nearby joint.

Damage to the kidneys is dangerous by the development of such an acute condition as renal colic. Often, urates form a large “coral” stone, which can completely block the lumen of the pelvis, obstructing the outflow of urine and provoking the development of hydronephrotic transformation (the kidney loses its function, turning into a “bag of urine”) with an outcome in chronic renal failure.

How is gout treated in men?

If a nutritional disorder leads to the development of gout symptoms, then treatment in men is a diet, namely table No. 6. It is based on a diet with restriction of purine-containing foods and the use of “alkalizing” products that neutralize uric acid.

The list of products whose use should be excluded include:

  • coffee, cocoa, chocolate;
  • legumes and spinach;
  • canned food and caviar;
  • salted and savory cheeses, sausages and smoked meats;
  • confectionery with butter creams;
  • red varieties of fish and meat;
  • Champagne wines and beer.

If, against the background of a diet, the symptoms of gout in men persist, treatment with medications is required.

In the phase of acute inflammation, when a gouty attack occurs, non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticosteroids (GCS), and drugs that affect uric acid metabolism are used.

NSAIDs are the “gold standard” in the treatment of active gouty arthritis and are widely used in the treatment of gout on all continents of the planet. They quickly block inflammation in the joint and articular syndrome, allowing you to restore joint mobility and returning a person to normal life. However, the minus of their use is that, with regular long-term use, they are able to provoke the development of ulcerative-erosive changes in the mucosa of the gastrointestinal tract, as well as increase the risk of liver and kidney failure. Therefore, patients who take NSAIDs for a long time need the appointment of gastroprotectors (literally – “protecting the stomach”) and dynamic medical monitoring.

GCS are anti-inflammatory hormones with high therapeutic efficacy in the treatment of gout. They are used both inside, and around – and intraarticular. In some cases, they can cause a number of adverse events, for example, systemic and local osteoporosis.

If NSAIDs and GCS do not help with a gout attack, drugs are additionally prescribed that block the metabolism of uric acid by reducing the activity of a number of enzymes or slowing down the reverse absorption of uric acid in the renal tubules and enhancing its excretion from the body.

Treatment of gout in men in the interictal period involves the appointment of specific therapy to prevent the formation and cleavage of existing crystals of sodium monourate. Such treatment is prescribed for frequent relapses of acute arthritis, the formation of tofus, the development of urolithiasis.

Preparations with a similar effect include Allopurinol, which reduces the formation of uric acid in the body due to the blockade of certain enzymes, and Probenecid, which disrupts the reverse absorption of uric acid in the renal tubules and enhances its excretion from the body with urine. The latter is not recommended for use with existing kidney stones.

But how to treat gout in men, if the diet did not bring the expected effect, and the symptoms of the disease persist?

An excellent method for the comprehensive treatment of gout, which enhances the effect of drugs, while reducing the duration of their intake and dosage, for many years remains physiotherapy, which is included in the standard of care for the treatment of this disease.

The most effective method of physiotherapy for gout include magnetotherapy, cryotherapy and phonophoresis. The advantages of magnetotherapy include its strong anti-inflammatory effect, a fairly “mild” effect, which is practically not accompanied by the development of side effects, and the possibility of carrying it out at home. Modern medicine allows the patient to carry out the procedure at home without any difficulties, using compact magnetotherapy devices for home use.

Cryotherapy, i.e. exposure to cold, has an excellent anti-inflammatory and pain relieving effect in acute attacks of gouty arthritis. Like magnetotherapy, cryotherapy can be carried out independently at home, without the help of medical specialists. The presence of such a device at home will help the patient cope with a gouty attack if it occurs at a time when it is impossible to immediately receive medical help.

Phonophoresis – local administration of drugs using ultrasound. It allows to achieve a high concentration of the drug at the injection point with minimal systemic effects. In addition, the very effect of ultrasound also has a good anti-inflammatory effect due to improved blood circulation.

Having examined the main symptoms of gout, the methods of its treatment and dietary features in men, I want to emphasize once again that the main guarantee of successful prevention and victory over any ailment is, first and foremost, a healthy lifestyle.

Gout and osteoarthritis (page 1 of 7)

1. Gout (“foot in a trap”)

A chronic disease associated with a violation of the uric acid metabolism is an increased content of uric acid (urate) in the blood, which is clinically manifested by recurring acute arthritis and the formation of gouty nodes (tofus).

T. Sydenham compared her to pain in the press. The exceptional cruelty of acute gouty arthritis has led to the emergence of numerous terrifying allegorical images.

Statistics

The spread of gout in the most developed countries is associated with a significant use of foods rich in purines (meat, fish) and alcoholic beverages.

Mainly men are ill. The first attack can be at any age, but more often after 40 years. In women, gout is observed in menopause.

Normal exchange uratov

Uric acid is the final product of the cleavage of purines. Reserves of uric acid in the body are normal 1000 mg at a rate of renewal within 650 mg / day, that is, 650 mg of acid decreases daily from the reserves and the same amount is replenished. It is excreted by the kidneys, the clearance is 9 ml / minute.

The source of uric acid formation in the body is purine compounds. The direct precursor of uric acid is guanine and xanthine.

– For women: 0,24-0,36 mmol / l;

– For men: 0,30-0,42 mmol / L.

The uric acid content above these numbers is regarded as hyperuricemia with a high risk of developing gout.

Etiology

Risk factors for gout:

  1. Male.
  2. Elderly age.
  3. Propensity to consume meat, alcohol, especially beer and wine. They contain molybdenum, which is a cofactor of the xanthine oxidase enzyme that converts xanthine to hypoxanthine (a direct precursor of uric acid).
  4. Fluctuations in the pH of blood and synovial fluid.
  5. Physical overloads, including static ones – in tight shoes – are especially frequent lesions of the big toe.
  6. Subcooling.
  7. Reduction of uric acid excretion by the kidneys.

a. NSAIDs, especially those containing phenacetin, can negatively affect kidney function (they are used to relieve migraine pain, which attacks are typical for people with gout).

b. Excessive accumulation of lead is recognized as one of the epidemiologically important factors that reduce renal excretion of uric acid. In England, local gout epidemics associated with the consumption of wine from Portugal have long been observed and clearly documented (wine was delivered in vessels that were coated with a composition containing lead).

c. Of particular importance as a risk factor is a partial decrease in renal excretion of urates under the influence of alcohol and diuretics. The widespread use of diuretics, with a pathology such as GB, significantly increases the number of people with hyperuricemia and the risk of developing gouty crises.

The main cause of gout is hyperuricemia, which results from

– Increased uric acid formation;

– Decreased uric acid excretion;

– Combinations of 1 and 2 factors.

Pathogenetic types of hyperuricemia

  1. Primary hyperuricemia. The most common cause of primary gout. This constitutional dyspurinism, that is, a family-genetic anomaly of purine metabolism, determined by several genes. Causes of primary hyperuricemia:

– Increased synthesis of endogenous purines, the so-called metabolic type of hyperuricemia, characterized by high uricosuria and uric acid clearance (the most common form).

– Violation of the excretion of uric acid by the kidneys (renal type of hyperuricemia), due to the low clearance of uric acid.

– A combination of 1 and 2 reasons.

Основная роль в патогенезе первичной гиперурикемии отводится генетически обусловленным нарушениям в системе ферментов, в первую очередь недостаточность фермента, принимающего участие в ресинтезе нуклеотидов из пуринов. Повышение активности этого фермента приводит к недостаточному использованию в организме пуринов и таким образом, повышению уровня уратов. Такой тип гиперурикемии характерен для синдрома Леша-Нихена. Повышенное образование пуринов может произойти под влиянием высокой активности фермента фосфорибозилпирофосфатазы (ФРПФ), который участвует в синтезе предшественников пуринов.

  1. Hyperuricemia due to the inability of the kidneys to compensate for the urate load by tubular excretion. Normally, urate is completely filtered in the renal glomeruli and completely reabsorbed in the proximal tubule, and then almost half is secreted by the distal sections and only 10% is excreted in the urine. In some patients, hyperuricemia develops due to the inability of the kidneys to compensate for the urate load by increasing tubular excretion. The mechanism for changing the activity of urate excretion is not completely clear.
  2. Secondary hyperuricemia.

– Renal failure. The most common reason.

– Blood diseases – Wakez disease, chronic myelogenous leukemia, pernicious anemia, myeloma, hemolytic anemia. Hyperuricemia due to the decay of cell nuclei and increased catabolism of cell nucleotides.

– Extensive psoriasis. Updating epidermal cells and enhancing the formation of purines from cell nuclei.

– Inhibition of tubular excretion and slowing the excretion of uric acid from the body with EG, myxedema, hyperparathyroidism, diabetes, gestosis.

Types of impaired purine metabolism

Metabolic type (hyperproduction gout)

Renal type (hypoexcretory gout)The main pathogenetic mechanism

Increased uric acid production in the body

Inadequate urinary acid excretion in urineFrequency

Common

RareUrinary uric acid excretion

High uricosuria (more than 3,6 mmol / day)

Below normal (less than 1,8 mmol / day)Uric acid level in the blood

The highest, can reach 0,8 – 0,9 mmol / l

Moderate increaseUric acid clearance

Normal

Reduced (3,0-3,5 ml per minute)The risk of precipitation of urates in collecting ducts

SmallFeatures of treatment

Uricodepressants shown

Showing uricosuric drugs

The following test is recommended to differentiate type of hyperuricemia.

The patient is taken on a seven-day diet with a restriction of purines and a complete prohibition of alcohol. In daily amounts of urine collected separately for 6 and 7 days, the uric acid content is determined and thus, its average excretion per day is established. It is tentatively believed that when excreted in 24 hours, 600 mg (3,6 mol) or more of uric acid, gout develops due to overproduction of urates, and when excreted 300 mg (1,8 mmol) or less – due to their insufficient excretion by the kidneys.

The pathogenesis of gout (as a chronic disease)

Hyperuricemia – increased excretion of uric acid and deposition of urates in tissues (sodium urate is selectively deposited in joints, vaginas, bursa, skin, kidneys) – penetration of urates into the synovial fluid – their precipitation in the form of crystals (penetrate into the cartilage and synovial membrane, where they are deposited in the form of needles) – through cartilage defects, uric acid penetrates to the subchondral bone, where tofuses are formed, which cause destruction of the bone substance, which is determined on the radiographs as round defects Kt of the bone (“punch”).

Of particular importance is the deposition of uric acid in the kidneys (gouty kidney or gouty nephropathy).

Gouty nephropathy is a collective concept that includes all renal pathology observed with gout:

– Tofus in the kidney parenchyma (50%);

– Urate stones (10-25%);

– Arteriolosclerosis with the development of nephrosclerosis.

Tofus and urate stones create conditions for urinary tract infection.

A distinctive feature of gout is interstitial nephritis as a result of the widespread deposition of urates in the interstitial tissue.

The causes of death are uremia, heart failure, and strokes resulting from renal hypertension.

The pathogenesis of an acute attack of gout

An acute attack develops after persistent and long-term hyperuricemia. Provoking factors:

1. Excessive alcohol consumption – an increase in the concentration of uric acid resulting from the normal metabolism of alcohol.

2. Prolonged fasting – an increase in the content of ketonic acids. All these substances disrupt the normal secretion of uric acid by the tubules and lead to a sharp increase in its content in the blood.

An acute attack of arthritis develops due to precipitation of sodium urate microcrystals in the joint cavity, which causes an acute inflammatory reaction of the synovial membrane.

The direct mechanism of the sudden precipitation of sodium urate crystals is unknown. It is believed that it is associated either with a rapid increase in the content of urate in the serum, which leads to the precipitation of crystals in the synovial fluid oversaturated with urates, or with a rapid increase in their amount in the blood, which contributes to their mobilization from the depot. The precipitated crystals are phagocytosed by neutrophils and synoviocytes – destruction of lysosomes – release of lysosomal structures, chemotactic substances, activation of complement, KKS (development of acute inflammation) – decrease in pH – precipitation of urate crystals (vicious circle).

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

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