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Joint inflammation which is called arthritis and pain that is caused by crystal deposits in the joints is known as gout. This metabolic disorder will usually affect a single joint and in some ways is associated with kidney stones since about 20 percent of the people who have this disorder develop kidney stones. Gout, which is also known as acute gouty arthritis, occurs when deposits of monosodium urate crystals accumulate in the joints due to an abnormally high level of uric acid in the blood. In some cases the joint inflammation becomes chronic and even deforming with time.
The normal human body will produce some uric acid that is a by product of the cells breaking down. Since the body is constantly breaking down cells and forming new ones there is always some uric acid in the blood. This, coupled with the fact that some foods contain precursors of uric acid creates a low level of uric acid that is eventually eliminated by the kidneys and will show up in most blood test. But, when the kidneys can not eliminate enough of this uric acid from the blood stream high levels cause monosidium urate crystals to accumulate in the joints causing gout. In some cases the body may produce large levels of uric acid when there is a hereditary enzyme abnormality or disease which causes the cells to multiply and be rapidly destroyed. There are also some types of kidney disease that make it functionally impossible for the kidneys to eliminate uric acid.
Gout attacks are known to strike without warning and are often triggered by an injury, consumption of large amounts of alcohol, fatigue, emotional stress or illness, surgery or consumption of large amounts of protein rich foods. Most attacks occur at night with severe pain in one or more joints. As the attack progresses the pain can become excruciating and the joint will swell with the skin around the area appearing tight, purplish red, shiny and warm to the touch. In most cases any contact with the skin can be very painful. Gout is often known to occur in the joint at the base of the big toe creating a condition that is called podagra. Podagra will also affect the ankle, knee, instep, elbow and wrist. It is believed that crystals form in these peripherally located joints since they are cooler than the central body parts. Since urate tends to crystallize at cooler temperatures there may also be crystals in the ears and other cooler areas of the body. A general sick feeling, fever, chills and rapid heart beat may also occur with the onset of gout.
A doctor will diagnose gout based on the symptoms and an examination of the affected joint. A blood test will be taken to check the uric acid level in the blood but it is common in acute attacks for this to be normal. A sample of the joint fluid will be removed by suction with a needle and if the needle shaped urate crystals are present when the fluid is viewed under a special microscope, the diagnosis will be gout. Traditionally colchicine will be prescribed and the pain will begin to subside within 24 hours. This drug is usually given in pill form but in severe cases it may be given intravenously even though it may cause stomach upset. Other side affects of colchicine would include diarrhea and on a more serious note, it may also cause bone marrow damage. Thus in many cases non-steroidal anti-inflammatory drugs are used instead.
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