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Common foot complaints:

Gout

Definition
Gout is a recurrent arthritis that primarily affects joints of the limbs. The most common joint affected by gout is the big toe joint. Other joints commonly affected include the ankle, knee wrist and elbow.

Gout is caused by the deposition of urate crystals in and about joints. This occurs due to high blood levels of urate. The high levels of urate are the result of increased production or decreased excretion of urate. Gout can be a complicating factor associated with a variety of other medical conditions or treatments. In most cases of gout the cause of the excessive blood urate levels are not realised.

The onset of gout is sudden. A joint, often the big toe joint, will become very painful. In this case walking becomes difficult. The joint may appear red and swollen. Gout attacks can initially be precipitated by an excessive intake of food or alcohol, trauma, or certain drug therapies.

Incidence / Age
Gout occurs in approximately 0.2% of the western population. It is more common in men than women, especially middle-aged men. It is rare in childhood before puberty.

Treatment
If you have pain in any joint of the body, especially if that joint is red or swollen, it is advisable to consult your General Practitioner. Blood tests, investigation of fluid within the affected joint and X-rays may be used to help confirm a diagnosis of gout. Treatment of gout will usually start with anti-inflammatory / analgesic drugs. You may also be given dietary advice. Following a diet that reduces your intake of purines can help reduce blood levels of urate.

Other drug therapies may be employed in the treatment or prevention of gout attacks. These include drugs such as 'Allopurinol' which reduces the production of urate, and 'Uricosurics' which increase the excretion of urate from the body. Both these drugs reduce blood urate levels and thus the likelihood of further gout attacks.

Outcome / Prognosis
It is important that any suspected gout attack is investigated. With early diagnosis, appropriate prophylactic and acute attack management, there is no reason why people suffering from gout should be significantly inconvenienced. If gout is poorly controlled extensive joint destruction can occur. It is essential that prescribed drug therapies and dietary advice be followed.

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