Gout is an inflamed joint condition caused by the deposition of uric acid salt crystals. This disease mainly affects people over 45 years of age. Men are more often susceptible to the disease than the female population. The inflammatory process can occur on any part of the joints.
Gout of the knee and toes is quite common. Concomitant diseases may be a risk factor. Diabetes mellitus and high blood pressure are the most likely causes of gout. Hereditary predisposition cannot be discounted. There are two types of disease: primary, caused by genetic factors, and secondary, consequences of earlier forms of the disease.
Acute attacks of gout can occur after drinking alcoholic beverages. The patient experiences severe pain. Symptoms of the disease can be quite varied.
The main cause of the disease is simple non-compliance with nutritional culture, simple overeating, consumption of fatty and spicy foods in excess of the norm, especially meat products. A sedentary lifestyle and nervous fatigue of the body also lead to the development of the disease. Gout of the knee joint occurs suddenly and is accompanied by pronounced redness of the inflamed area. Acute intense pain occurs from the slightest touch to the sore knee. The symptoms are caused by poor excretion of uric acid from the human body.
The pain syndrome can occur suddenly and quickly subside. In rare cases, the pain continues for several weeks. If you immediately pay attention to these symptoms during an exacerbation, then you can avoid unpleasant complications in the future.
How to identify symptoms of gout in the knee? The main indicator of an inflamed condition will be a change in the color of the skin around the joint. An attack usually occurs after heavy consumption of meat in combination with alcohol. Pain begins to torment a person in the evening or at night. A sudden outbreak with a rapid increase in body temperature forms a subcutaneous focus of inflammation in the knee joint.
Laboratory tests will help accurately determine the diagnosis. It is necessary to establish the quantitative level of uric acid in the blood and determine the daily rate of urine output from the body. The acid level in the blood should not exceed 420 µmol/l in adult men and 350 µmol/l in women.
When diagnosing gout, the urinary tract and kidneys are subject to ultrasound examination. This is necessary to establish their general condition and influence on the development of the disease.
Treatment of gout should begin with diet. All products containing uric acid compounds are excluded from the daily diet. This measure will reduce the amount of uric acid in the blood. All foods containing purine and nitrogen bases (kidneys, brains, tongue, liver) should be strictly excluded from the diet. Lean meat can be consumed in extremely small quantities, 200-300 g per week.
All food should be fresh. You should reduce your salt intake to 5 g per day. However, this does not mean that you need to starve. Hunger causes an increase in uric acid in the body. By following the basic rules of dietary nutrition, you can effectively treat the disease.
At the initial stage of treatment, the main task is to relieve pain and alleviate the patient’s condition. For severe pain, anti-inflammatory drugs are prescribed. Gout is treated over a long period of time and systematically. Complex therapy is carried out until the development of the disease stops. In rare cases, a complete cure is possible. It is effective to use blockade injections immediately after eliminating an acute attack of the disease. Treatment should be aimed at restoring the entire musculoskeletal system of the body.
Medicine that helps fight an acute attack of the disease
A non-steroidal group of drugs (ibuprofen, diclofenac, naproxen) will help to attenuate inflammatory processes in the joint structure of the knee. Colchicine will reduce acute inflammation during a gout attack and have a tonic effect on muscle tissue.
The oldest and most effective remedy for relieving inflammation and reducing subcutaneous temperature is cabbage leaf. Place a large cabbage leaf over your knee joint and wrap it around your knee. This procedure must be applied every day. It is recommended to keep such a compress for no more than 4 hours, otherwise the medicinal properties of cabbage will be lost. It is better to update the sheets more often. In some cases, you can lubricate the knee with honey and then apply the sheet.
There are several more proven traditional methods of treatment.
Preventive measures should be aimed at promoting a healthy lifestyle. Maintain food culture. An active lifestyle should consist of an even distribution of physical activity and frequent walks in the fresh air.
Massage of the kneecap joint is carried out with the aim of quickly resolving exudate and eliminating muscle tension. Sanatorium-resort treatment will help reduce the risk of further development of the disease.
Gout , or gouty arthritis , is a disease in which metabolic disorders occur in the body and uric acid salts are deposited in the joints. This is a very unpleasant but easily treatable disease.
Gout is relatively uncommon. Although I hear the word “gout” almost every day. For example, most grandmothers call arthrosis of the big toe “gout.” This is what they usually say: “Gout has grown on my leg.”
In fact, gout, although it affects the same big toes, most often affects men. In women, gout (real, true gout) is several times less common.
Previously, some 100 years ago, gout was generally considered an exclusively male disease. But in our time, due to the fact that women began to eat better, eat more meat and sausages, gout began to occur much more often among them than, for example, a century ago.
In addition, gout in women has become more common due to the use of certain medications, primarily medications for high blood pressure. Some drugs to reduce high blood pressure, when used for a long time, lead to an increase in the concentration of uric acid in the body.
But still, in men, gout manifests itself much more acutely and “aggressively”, since the concentration of uric acid is significantly influenced by male sex hormones.
Below I will tell you about the symptoms , signs and treatment of gout , as well as what diet you should follow for this disease.
“Classical” gout belongs to the group of arthritis. It develops in people who have a hereditary predisposition to this disease. Moreover, the potential patient may not even be aware of his heredity.
For example, if his parents or relatives lead a healthy lifestyle, do not abuse alcohol and eat properly, then the disease may not manifest itself in them and will exist all their lives only in a latent, hidden form.
And our potential patient, who has a predisposition to this disease, will provoke the disease in himself only if he leads a not entirely healthy (from the point of view of a tendency to gout) lifestyle.
Thus, a typical gout is often (but not always) an overweight man who abuses either alcohol or so-called “purine foods”: meat, meat soups, smoked meats, fish and salted foods, offal (liver, kidneys), beans, beans , chocolate, grape wine.
When these products are abused, there is an increased formation of uric acid in the blood, which, in turn, forms a poorly soluble sodium urate salt. When the concentration of uric acid in the blood reaches a maximum level, its salts in the form of microcrystals are deposited in the joint cavity, forming a kind of “depot” there.
The presence of microcrystals of sodium urate in the joint cavity is a serious irritant for it. But nevertheless, crystals can remain in the joint for a long time asymptomatically - until some provocation (physical overload, stress, prolonged fasting or, conversely, too much “purine foods” and alcohol) provokes an acute gouty attack, that is attack of gout. Regular acute attacks of gout are the main symptom of this disease.
The first attacks of gouty arthritis are almost always short-lived. The attack usually begins suddenly, most often at night. In most cases, the joint of the big toe becomes inflamed (sometimes one, sometimes both). Less commonly, the thumbs, knee, ankle, elbow joints, heel tendons, and very rarely the wrist joints become inflamed.
The pain is such that, according to my patients, it makes you want to literally “climb the wall.” The affected joint swells, turns red, and the skin over it becomes bright red or purplish and hot to the touch. Even a light touch to the inflamed joint or the slightest movement in it causes unbearable pain. The patient suffers for 3-4 days, when suddenly the attack passes, as if nothing had happened.
However, after some time, the pain just as suddenly recurs. Moreover, if at the beginning of the disease the intervals between attacks are quite long, from one to eight months, and the attacks themselves are short-lived, then over time everything changes. The attacks are becoming longer and longer, and the intervals between them are becoming shorter.
Eventually, there comes a time when the pain in the joints becomes constant, and there are practically no intervals between attacks. This condition is called "status gouty", or chronic gouty arthritis. In chronic gouty arthritis, articular cartilage is destroyed, and special defects are formed in the bones adjacent to the joint - “punches”, which are a cavity filled with microcrystals of sodium urate.
In addition, sodium urate crystals can be deposited even under the skin, forming whitish, hard nodules filled with a pasty mass. Such nodules are called tophi, and most often they are located on the ears or near the joints. Sometimes tophi break through and uric acid crystals are released through the resulting fistula. Fortunately, usually within a few days after the tophi breaks through, the wound heals without consequences.
In addition to the above troubles, gout, especially advanced ones, is almost always accompanied by the deposition of urate in the kidneys, which leads to urolithiasis and sometimes to inflammation of the kidneys (pyelonephritis).
Female variants of gout are usually much milder. Women very rarely have acute gouty attacks, and tophi and punctures in the bones are much less likely to form. Most often, female gout manifests itself as mild chronic pain in the knee or ankle joint. And an experienced doctor can guess that this is not arthrosis only by the severe swelling of the inflamed joint, which is uncharacteristic of arthrosis.
Having assumed that the patient has gouty arthritis (and in classic cases this is quite easy), a competent rheumatologist or arthrologist will refer the patient for an x-ray of the hands and feet, as well as a biochemical blood test.
With advanced gout, the doctor can easily detect characteristic gouty “punches” in the periarticular bones on x-rays of the hands and feet. A blood test will show an increase in uric acid levels. If such an increase is clearly expressed and is combined with the presence of “punches” in the bones and characteristic gouty symptoms, then the diagnosis is considered reliable, and then we only need to select the correct treatment.
The problem, however, is that if you do a uric acid test at the very moment of the attack (and usually it is at this time that the patient goes to the doctor), then such an analysis may not record any abnormalities. That is, at the time of an attack, the level of uric acid in the blood may turn out to be normal (after all, at the time of an attack, the maximum amount of uric acid goes into the inflamed joint).
Therefore, it is necessary to measure the level of uric acid in the blood several times, including between attacks. But gout patients often don’t have the patience for this. As soon as the next attack “subsides,” they often completely stop thinking about their health again.
Meanwhile, without correct diagnosis and without proper treatment, gout can lead to very undesirable consequences not only for the joints, but also for the kidneys.
Continuing the topic, I would like to note that, despite the frequent mention of the term “gout” in the literature and in conversations, in reality it turns out that the correct diagnosis of gout patients is not always made and is often very late. Sometimes you have to deal with monstrous diagnostic errors.
For example, at the time of an attack, surgeons managed to diagnose one of my patients with “gangrene of the big toe” and amputated the toe inflamed by gout. Literally 3 weeks later, his big toe on his other foot became inflamed, and the patient was about to amputate that too! Fortunately, the man realized that this time he should consult another doctor, and turned to me for help. Upon examination, it immediately became clear that the patient did not have gangrene, but classic gout. I prescribed the anti-gout drug colchicine to the patient, and the attack was eliminated literally in one day! The next day there was no trace left of the imaginary gangrene.
Another patient was treated for arthrosis for seven years, despite the fact that his joints became inflamed in attacks, alternately, about once a month, and the inflammation never lasted longer than 5-7 days. The most surprising thing in this story was that in numerous tests of blood taken from a vein, the patient’s uric acid simply went off scale. She was more than 2 times higher than normal! But doctors managed to ignore this over and over again. And they continued to stick to their line. During one of the attacks, the man even had time to have his knee operated on and a completely healthy meniscus was removed. But the operation, naturally, did not bring any relief to the patient. The knee periodically continued to become inflamed along with other joints.
Only after the man came to see me and laid out a pile of tests in front of me, which clearly showed a constant increase in uric acid levels, was the patient finally given adequate anti-gout treatment. And just a month after the start of treatment, gout attacks, for the first time in all the past years, began to disappear. And then they stopped altogether.
After diagnosing a patient, I usually say, without any irony, “Congratulations, you have gout.” I’m really not being ironic, because of all the possible diagnoses, this is one of the most favorable. Gout is very easy to treat and is not particularly difficult for a competent specialist.
Although here, as often happens, there is a “fly in the ointment.” Yes, gout is very treatable, but many gout patients do not want to accept the conditions that are necessary for recovery - since the “conditions” are the refusal of those foods (and alcohol) that caused metabolic disorders. And when I tell patients that to get rid of the disease they need to give up their favorite foods and alcohol, they often simply don’t want to hear me.
That’s why every time I have to patiently explain that without a diet there can be no talk of recovery, no matter what “cool” medications are used. Another thing is that in many cases the diet is a temporary measure, and if certain conditions are met, after a year or two the strict restrictions can be lifted.
Drug therapy for gouty arthritis consists of two components: treatment of an acute attack and therapy of the gout itself.
To relieve an acute gout attack, non-steroidal anti-inflammatory drugs (Voltaren, ibuprofen, Movalis, Nimulide, etc.) or a special short-acting anti-gout drug - colchicine - are successfully used. A vodka compress can be applied locally to the sore joint.
Drugs to relieve an acute attack are used for a short period of time, in a short course of three to seven days. And directly for the treatment of gout, in the absence of contraindications, for several months or years a drug is used that reduces the formation of uric acid in the body - purinol, also known as allopurinol .
Following a diet and using purinol (allopurinol) leads to normalization of the patients' condition within the first month of therapy. Although during the first week, during therapy with purinol or allopurinol, an exacerbation of the disease may even occur. But then the attacks become weaker and occur less and less often, and over time they stop altogether.
And after about a year, if my ward is feeling well, I allow some relaxations in his regime. I ask the patient what he would like to stop - diet or medication, since we can limit ourselves to one thing or the other. If the patient is already accustomed to the diet, then there is no point in breaking it. In this case, it is better to reduce the dose of medications taken or stop them altogether.
If the patient finds it difficult to tolerate dietary restrictions, then you can abandon the diet, but continue taking medications. However, the medications will have to be used for several years - which, in general, is not scary, since purinol (allopurinol) rarely causes any side effects and is generally well tolerated by patients.
Article by Dr. Evdokimenko© for the book “Arthritis”, published in 2004.
Gout of the knee joint is a disease in which the human body's metabolism is disrupted, as a result of which uric acid salts begin to be deposited in the knee and other joints.
The disease occurs predominantly in men, since male sex hormones affect the concentration of uric acid. Gout is less common in women.
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A typical patient with gout is usually an overweight man who likes to eat meat, fish and smoked meats, offal, and who abuses alcoholic beverages.
These foods cause excess uric acid in the blood, which produces the insoluble salt sodium urate.
When the concentration of uric acid reaches the limit, salt crystals settle in the joint cavity.
Thus, a “reserve” of salt is formed there, which is waiting in the wings to attack the patient with attacks. Attacks are provoked by stress, overeating purine foods and alcohol abuse.
Attacks of the disease begin at night with excruciating severe pain.
At the beginning of the disease, attacks are short-lived, and the intervals between them are long. However, as the disease progresses, everything changes.
The diagnosis is made based on examination, according to the patient’s words (history).
A laboratory blood test is also done, which indicates an increased ESR, as well as an increased content of fibrinogen and alpha 2-globulin.
Urate crystals are found in the intra-articular fluid, and uric acid is higher than normal in the blood.
An x-ray reveals defects in the bones of the knee as a result of a severe course of the disease.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
In case of acute gouty arthritis, it is necessary to provide complete rest to the patient, apply a cold wrap to the affected area, followed by emergency drug therapy.
The treatment of gout of the knee joint must be approached comprehensively, which consists of basic therapy and physiotherapeutic treatment.
First you need to relieve the acute pain from gout.
The drug for pain relief is Colchicine , which can reduce the acute period of the disease to two days. It is prescribed at a dose of 0.5 mg, no more than 6-8 mg per day in tablets, taken every hour until the attack subsides during the day.
It cannot be taken for more than a day. In such a rhythm, it is permissible to use colchicine for only 1 day. In severe cases, Colchicine is administered intravenously.
Medicines for the main treatment of gout of the knee joint are of two groups: Uricodepressants and Uricosuric drugs.
Uricodepressants help reduce the production of uric acid and are prescribed to patients with impaired renal function.
The most common gout tablets in this group are allopurinol and thiopurinol.
Purinol and Thiopurinol are used as uricodepressants, which slow down the formation of uric acid; they are taken after meals once a day.
Uricosuric drugs in the form of Sulfinpyrazone and Probenecid increase the excretion of uric acid from the body.
In addition, the use of non-steroidal anti-inflammatory drugs (Ibuprofen, Voltaren and Movalis) and corticosteroids also has a good effect in the treatment of gout.
In parallel, patients are prescribed long-term therapy with Colchicine (1 mg per day). This technique is effective; it reduces the occurrence of new attacks without causing addiction.
The use of physiotherapeutic treatment for gout is a fairly effective method. These are physical therapy exercises with the intake of mineral (alkaline) water, which you need to drink about 2 liters per day.
Treatment of gout of the knee joint is impossible to imagine without following a strict diet.
If gout is caused by excess protein foods, drinking alcohol and secondary gout, treatment may involve eliminating the risk factor. In such cases, simple home remedies can help with normalizing your diet and lifestyle.
Traditional medicine has in its arsenal many effective ways to alleviate the condition of patients during attacks.
The main folk remedies are:
A decoction of lingonberries is considered an effective remedy for healers.
Boil 2 tbsp in a glass of water for 15 minutes over low heat. l. herbs.
The resulting decoction is drunk one day, and a new one is prepared the next day. This continues the procedure until recovery.
A compress of salt and honey relieves pain well. Place a tablespoon of honey and salt on gauze or soft cloth and apply to the sore joint.
Red clay compresses with wine vinegar are also useful.
A mixture of 50 g of iodine with 100 g of ammonia and 100 g of camphor alcohol, after mixing, is infused for 2-3 days.
Sore areas of the body are moistened with a tampon.
Melted unsalted butter 250 g, bring to a boil, skim off the foam and add a glass of wine alcohol. Light the resulting mixture and wait for the alcohol to burn out.
Apply the remaining warm mixture to the affected areas.
Take a glass of whole milk, mix with 25 g of naphthalene, place the resulting mixture in a water bath and bring to a boil, stirring. You need to boil for 10 minutes. Keep the container with the mixture in a cool, dark place. Lubricate sore joints morning and evening.
An ointment made from birch buds will help , which are placed in layers in a bowl with butter, the thickness should be 2-3 cm. The lid of the dish is sealed around the dough, kept in a cool, dark place for about a week. After decanting the oil, add camphor powder 70 g and mix gently.
Sore joints are rubbed several times a day (before bedtime).
Horse chestnut has long been known for its healing properties.
You need to prepare a collection of fruits, bark and flowers of this medicinal plant in equal parts, then pour one tbsp. l. Collect a glass of hot water and boil for about 20 minutes.
Take 20 drops orally after meals.
A chestnut foot bath helps. Both flowers and fruits are suitable for this. About one hundred grams of crushed chestnut raw materials are boiled for half an hour. The broth is poured into the bath and taken for about 15 minutes.
Chestnut healers and ointment are prepared: take equal parts of camphor oil with lard and mix with 1 part of chestnut fruit powder. The resulting ointment is smeared on a piece of rye bread, then applied to the sore spot.
The tincture is prepared within a week from two tablespoons of chestnut fruits, bark and flowers per half liter of vodka. Take 1 tbsp three times a day. and also apply as a rub on affected joints.
The Japanese method of treating gout with the simultaneous use of cold and heat also deserves attention.
For the treatment procedure, you need to prepare two baths, fill one of them with cold water, place a little cereal in the other and fill it with hot water. When the cereals have steamed, you need to immerse the sore leg in a bath of cold water for 5 seconds, then immediately into the container with the cereals.
The procedure is carried out daily for 2-3 months.
Patients are prescribed treatment with vitamins, as well as drugs to improve blood microcirculation.
Increased intake of simple clean water (about 2.5 liters) together with alkaline mineral waters from springs improves kidney function and helps remove urates from the patient’s body.
Useful local application:
— Warm compresses on sore joints with medical bile or Dimexide
— “Fulflex” ointments for resolving inflammation.
All this is done while following a strict diet.
In order to treat knees for gout with medications more effectively and quickly, the patient must adhere to a diet.
To do this, he needs to give up meat dishes and offal (liver, kidneys), and in addition to them:
It is useful for gout to make up your diet from boiled and fresh vegetables and fruits.
Food should contain as many vitamins and microelements as possible. It is recommended to limit the consumption of bell peppers, celery, cabbage of any variety, radishes and radishes. And berries and nuts are healthy.
Sweets are allowed in the form of jam and jam, marshmallows, candy, but not chocolate.
Dairy products allowed are kefir and cottage cheese, yogurt and sour cream, unsalted and low-fat cheeses. In the periods between attacks, you can add boiled or baked veal fillet or lean chicken to the menu.
Taking pills for a long time can cause damage to your stomach. To protect it, you need to drink milk, but not whole milk, but processed milk. Porridge should be cooked in milk.
This disease requires treatment even when there are no attacks.
We must constantly remember and follow preventive measures, which consist of a healthy lifestyle without alcoholic beverages, taking medications that help remove excess uric acid from the body.
Following a strict diet is important.
Only if such conditions are met can you live without injections and taking pills.
Gouty arthritis develops in people with disorders of purine metabolism. The end product of the breakdown of purines is uric acid. It is excreted by the kidneys.
Excessive synthesis and insufficient excretion of uric acid from the body leads to its accumulation in the blood. The solubility of uric acid salts (urates) in the blood is low. Reaching peripheral zones, where body temperature is lower, urates cool and crystallize. The crystals resemble sticks or needles with broken ends, about 10 microns in length. First, they accumulate in the intercellular space of the synovial (articular) fluid of the small joints of the foot and toes.
Crystals are perceived by the body as foreign particles. They are attacked by cells of the immune system - phagocytes. However, they fail to destroy the crystals. The death of immune agents triggers an inflammatory response. The patient develops arthritis of the foot. Joint damage is an early manifestation of gout.
As the disease progresses, inflammation occurs in other joints. Not only the joints of the legs are affected, but also the joints of the upper extremities. During a gout attack, one joint or several joints may become inflamed at the same time. In severe cases of the disease, sometimes all joints of the limbs are affected.
Inflammations recur at different intervals. The interval between attacks can be several months or years. At this time, the gouty person feels well and does not complain of malaise. Against the background of chronic gouty arthritis, attacks appear more often, but are less pronounced.
Photo. Gouty foot
The advanced form of the disease is characterized by continuous attacks of arthritis in one or more joints. They are observed for several months in a row. All this time, moderate inflammatory processes do not subside. This condition is called status gouty.
Inflammatory processes have a destructive effect on joints. The joints become deformed and become stiff. The patient develops gouty arthrosis. Changes lead to deformation of the organ. The range of motion decreases. A person suffers from constant pain in the limbs. Arthrosis most often develops in the joints of the feet (bumpy gouty foot in the photo).
The spread of the inflammatory process to the upper extremities is accompanied by the appearance of tophi. Tophi are collections of uric acid crystals. Urates are deposited on the surface of articular cartilage, in the synovium, in tendons and in bones. Gout bumps appear in the skin, under the skin and in the muscles.
Tophi are painless yellowish nodules. They usually form near a joint (usually the elbow or knee) and can reach the size of a chicken egg. Tophi localized in the musculoskeletal system cause gouty polyarthritis. An ulcer may appear on the tophi. Later, a fistula appears in its place, from which a pulp containing uric acid salts is released.
Urate crystals accumulate in the ureters and renal pelvis. They cause nephritis (inflammatory kidney disease) and urolithiasis. Due to impaired renal function, the excretion of uric acid decreases even more and the disease progresses.
A metabolic disorder that causes uric acid to accumulate in the blood causes obesity and loss of sensitivity of body tissues to insulin. Insulin that is not destroyed by the kidneys and liver accumulates in the blood and causes a decrease in glucose consumption by tissues. Therefore, gouty polyarthritis is often accompanied by diabetes mellitus.
Metabolic disorders cause the accumulation of low-density lipoproteins in the blood. They form atherosclerotic plaques on the walls of blood vessels. People with gout often have high cholesterol levels. They suffer from atherosclerosis and arterial hypertension. As gout progresses, coronary insufficiency develops.
Pathology increases the likelihood of myocardial infarction.
The mild form of the disease is characterized by the occurrence of attacks no more than 1-2 times a year. The patient only has 1 or 2 joints inflamed. After an exacerbation, the functions of the articulation are completely restored. Between attacks, the gouty person feels completely healthy. He does not have any renal dysfunction or other concomitant diseases. Tophi are completely absent. In some patients, single gouty bumps are found, not exceeding 1 cm in diameter.
With a moderate illness, the patient suffers from attacks at least 3 to 5 times a year. Gouty arthritis of the knee joint develops against the background of inflammation of the metatarsophalangeal joint (the joint of the big toe). The source of inflammation may also be in the ankle joint. At this stage of the disease, moderate deformation of one or two joints is visible. Multiple small tophi are detected. Gout is diagnosed with renal stone disease.
If the disease is severe, the patient experiences attacks almost every 2 months. He develops large tophi. The examination reveals renal dysfunction and other concomitant diseases.
An attack of gouty arthritis develops suddenly at night or early in the morning. At an early stage of the disease, the inflammatory process is detected in the metatarsophalangeal joint. Sometimes gouty arthritis of the ankle joint may develop during the first attack. In rare cases, a focus of inflammation appears for the first time:
The process is proceeding rapidly. Severe bursting pain appears in the affected joint. Patients consider gouty pain to be the most severe pain they have ever experienced. The leg in the joint area swells and increases in size almost 2 times. The skin becomes bluish-purple, hot and very sensitive. Even the touch of a light cloth increases the suffering of the patient. During an attack, body temperature may rise to 38 - 39? C. Due to inflammation, the patient's motor activity is limited. He cannot put weight on his leg with an inflamed joint. Severe pain does not allow him to even move it.
Symptoms of gouty arthritis disappear as suddenly as they appear. Relief occurs within 3 or 4 days even without treatment. The joint fully restores its functions. Therefore, the patient may mistake the attack for a consequence of injury.
Subsequent exacerbations may last longer. A person suffering from chronic gouty arthritis often knows about an impending attack in advance. A couple of days before an exacerbation, unpleasant sensations arise in the joint. The patient feels:
In women, gouty arthritis is not as severe. The disease manifests itself as moderate pain in the knee or ankle joint.
Symptoms of gout are often mistaken for signs of gonarthrosis. It is possible to distinguish arthrosis of the knee joint from inflammation only by characteristic swelling.
Treatment of gouty arthritis should begin immediately after the first symptoms appear. Pain syndrome is relieved with non-steroidal anti-inflammatory drugs:
Drugs that affect uric acid metabolism are also prescribed:
If the patient’s condition cannot be alleviated, the doctor prescribes corticosteroid drugs:
An effective combination drug Ambene contains the glucocorticoid dexamethasone, non-steroidal anti-inflammatory drugs phenylbutazone and sodium salicylamide - O - acetate, as well as cyanocobalamin and lidocaine hydrochloride. The components of the drug reinforce each other, allowing you to reduce the dose of dexamethasone.
If treatment is started within 30 to 60 minutes after an exacerbation, inflammation and pain will disappear within a few hours. During the first hours of an attack, most of the daily dose of nonsteroidal anti-inflammatory drugs is administered. In the absence of therapy, the inflammatory process can develop for several weeks.
When a sign of attenuation of the inflammatory process appears, the dosage of Colchicine is reduced or the drug is discontinued. The disadvantage of Colchicine treatment is its poor tolerability by patients. They complain of nausea, vomiting and diarrhea. Gastroenteritis and neuropathy sometimes develop. Patients with severe forms of the disease are prescribed Colchicine intravenously.
After the attack has stopped, treatment of gouty arthritis is continued with drugs that prevent exacerbation. The patient is prescribed uricosurics (increase the excretion of uric acid) and uricostatics (inhibit the synthesis of uric acid).
Uricosurics are not prescribed for high levels of uric acid in the blood and when kidney failure is diagnosed. In other cases, the patient is prescribed Sulfinpyrazone or Probenecid.
Uricostatics are recommended for all patients with gouty arthritis. Usually the doctor prescribes Allopurinol. Medications can prevent attacks, reverse the development of tophi and improve the excretory function of the kidneys.
In order to prevent the development of nephropathy and urolithiasis, gout patients take alkalizing medications (Magurlit, Uralit, Blemaren). While taking medications, urine pH levels should be monitored. It is beneficial for patients to drink alkaline mineral waters.
If there are signs of osteoarthritis of the hands, knees or other joints, it is recommended to use anti-inflammatory drugs for external use (Dolobene, Finalgon, Nimulid gel, Bischofite gel).
Treatment with folk remedies helps to significantly alleviate the patient’s condition during an attack.
Symptoms and treatment of the disease depend on the gout diet. If he manages to completely eliminate certain foods from the menu or significantly reduce their consumption, attacks will bother him much less frequently. In some cases, the diet helps avoid attacks for years.
The patient needs to avoid offal:
It is necessary to reduce the consumption of protein (up to 1 g per day per 1 kg of body) and salt (no more than 5 g per day).
It is advisable to eat more often:
They can be eaten fresh, frozen or dried. Compotes and juices made from these berries are useful. You need to prepare rosehip decoctions.
Gout of the knee joint is a joint disease that develops against the background of metabolic disorders in the body. The development of the disease causes the deposition of urates, that is, uric acid salts, in the joint. Because of them, characteristic nodules and bumps (tophi) appear in the affected area. Untimely treatment can lead to urolithiasis, kidney failure and other serious problems.
Gouty arthritis of the knee joint is one of the common ailments of this kind, but this does not make it any less dangerous, because failure to seek help in a timely manner can most likely cause disability in the future. The joint is destroyed under the influence of salts. The kidneys also suffer from gout, which in the most severe cases leads to death.
The disease has been known since ancient times, because it was called the “disease of kings.” Its prevalence currently in Russia is 1%. Men suffer from it more often, women are less susceptible, and gout is not observed in adolescents or children.
Increased production of uric acid causes the disease. Sometimes its amount can be normal, but gout still develops. This happens when renal function is impaired, when the organ cannot cope with the removal of acid.
There is a category of patients who are more likely to get the disease:
Sometimes gouty arthritis of the knee joint develops due to concomitant diseases of the joint . Reactive synovitis or bursitis of the knee, which has not been treated for a long time, is likely to be complicated by arthritis.
The initial stages are almost imperceptible, but later gout of the knee joint gives clear symptoms. At the time of exacerbation, severe pain occurs, as well as redness. It often spreads to the toes, feet, and hip area. The discomfort noticeably worsens when the limb is moved to a vertical position.
Fever also appears when gout of the knee joint worsens. Symptoms are complemented by characteristic swelling of the foot, and the affected joints acquire a bluish tint. In the area of the joint itself, the temperature can reach 40 degrees.
The attack is long. Sometimes gout of the knee joint, the symptoms of which are described above, worsens for 3-10 days. The functioning of the limb is not fully restored, and gradually the period between relapses is greatly reduced.
When gouty arthritis of the knee becomes chronic, most symptoms go away, but noticeable nodules form in the affected area . This stage of the disease is less susceptible to treatment.
There are instrumental and laboratory diagnostic methods. As with reactive arthritis in children, a biochemical blood test and urine test are necessary. In this case, they are needed to detect excess uric acid.
In most cases, a puncture called arthrocentesis is sufficient for diagnosis. The fluid taken from the joint is examined and treatment is prescribed. For people whose knee has been injured, gout of the knee joint is detected using an x-ray.
There are a number of auxiliary and basic measures if gout of the knee joint occurs. Treatment is aimed at relieving negative symptoms, preventing worsening of the knee condition, as well as getting rid of the inflammatory process. Supportive therapy includes taking into account the factors that prompted the development of the disease. So, for diabetes or hypertension, appropriate treatment is selected, and for obesity, weight loss will be required.
Therapy should not be limited to medications only. An integrated approach prevents the recurrence of gout and the development of complications.
Initially, drug therapy helps relieve acute symptoms. For this purpose, the drug colchicine or other analgesics are often used. In the future, uricodepressants are used, which reduce the production of uric acid, as well as uricosurics. The latter help remove acid accumulated in the body. Anti-inflammatory drugs (antibiotics or corticosteroids) are selected by a specialist, since some types of drugs are prohibited from being taken for this disease.
As in the treatment of synovitis of the knee joint, physiotherapy (ultraviolet light, reflexology) is used . The load on the joint should be limited, but exercise therapy cannot be canceled. They also include a special diet, and not only if you are overweight. Chocolate, alcohol, fatty foods, coffee and all foods that can cause gout are excluded from the diet.
If gout of the knee joint has developed, treatment with folk remedies will help and make drug therapy more effective. Among traditional therapy recipes, special attention should be paid to decoctions with a diuretic effect. The following herbs have this:
If gout of the knee joint has worsened, treatment with folk remedies will help quickly remove excess water, and some decoctions will also have an anti-inflammatory effect and reduce fever.
Gout of the knee joint is a very serious disease. Treatment with folk remedies must be approved and agreed upon with a doctor. It is prohibited to replace traditional medicine with medication therapy!
The following recipes can also help in treating the disease:
It is advisable to supplement complex therapy with sanatorium treatment or undergo preventive therapy for the purpose of rehabilitation after illness.
There are ailments whose presence in most people is associated with age-related changes in the body. We are talking about gout of the knee joint, which affects many older people. Gout is one of the most dangerous types of diseases of the leg joints. It usually affects the feet and knee. This disease is no less common in the area of the hip joint and big toe.
A characteristic feature of gout is the formation of nodules of varying sizes on the legs. The symptoms of gout in the legs are very recognizable: painful attacks, redness, swelling in the area of the feet, big toe, knees. Diagnosis of gout in the first stages of its development is complicated by the fact that the symptoms of the disease resemble other joint diseases. Gout cannot be completely cured, but there is always a real chance to slow down its development by blocking pain symptoms in the joints of the legs.
The main symptoms of the disease have been known to mankind since ancient times. The disease is mentioned in the writings of Hippocrates. He, having studied joint ailments, came to the conclusion that the cause of gout in the hip joint, big toe joint, knee joint and foot deformity is the consumption of food and alcohol in unlimited form. Isn’t it because of the same reasons that illness occurs in our time? About 200 years ago, science made a discovery: there is a relationship between this disease and uric acid. Its excess triggers the mechanism of destructive changes in the joints. If the cartilage of the joint is destroyed, the disease is inevitable. This disease is considered chronic. Symptoms of the disease are:
Often the disease begins as a consequence of complications of arthritis, which can provoke its appearance. Gout of the knee joint can occur due to injury or fracture of the leg. The consequences of injuries and fractures of the legs can become a trigger for other ailments that complicate the condition of the joints. That’s why timely diagnosis is so important, which will help you choose the optimal treatment for your feet, combining methods of official and traditional medicine.
Gout, having passed the initial stage of its development, is recognized quite simply. Strong painkillers cannot relieve severe pain in the joints. Attacks of pain in the joints of the legs most often occur at night. Redness is visually noticeable in the area of the joints of the big toe and knee area. Joint swelling is an important sign of gout in the leg. Its symptoms are somewhat reminiscent of colds. The person experiences general weakness, lethargy, and apathy. Gout is rarely accompanied by a general increase in body temperature. But in the area of the affected leg joint it actually increases to a critical level for the human body - 40°C. Even when the pain and temperature in the joints subside, the legs do not become more mobile. Attacks of pain in the legs last on average from two days to a week. When the inflammation of this area is relieved with the help of medications and folk remedies, gout recedes. But after a while it returns.
It is customary to distinguish three stages of gout of the knee joint, each of them has its own treatment, which does not exclude universal remedies for any stage of the development of the disease. Acute arthritis of the legs is the first stage of gout development. Interictal gout is the second. The chronic stage of the disease is the third and most severe type of disease.
A disease of the toe or knee can only be detected in a timely manner using biochemical analysis. To determine the exact condition of the joints, blood is taken. If the level of uric acid in it is elevated, this is already a sign of gout of the thumb, knee, or hip joint. A biochemical urine test will also show the real condition of the leg. That is why people who have pain in the entire leg or localized in the knee need these tests for gout factors. If the legs begin to hurt severely for no reason, arthrocentesis is also prescribed. There is fluid in the joints. This type of analysis will check it and determine the condition of the leg joint. The radiographic method is also an effective method in diagnosing the disease. It is recommended to be performed regularly for those people who have knee injuries.
The causative agents of the disease primarily include non-compliance with the simplest nutritional rules:
Nervous fatigue and a sedentary lifestyle can negatively affect your health and provoke illness.
Gout of the knee joint occurs suddenly and is expressed in redness at the site of inflammation. Acute pain when touching the painful area and other symptoms appear due to impaired excretion of uric acid from the patient’s body.
Painful sensations appear unexpectedly and disappear abruptly. Sometimes the pain persists for several weeks. If you pay attention to the symptoms during an exacerbation and promptly seek help from a doctor, you can exclude the occurrence of complications. Timely treatment is the key to healthy joints.
The first sign of the disease is hyperemic skin in the area of the affected joint. An attack of the disease and aggravated symptoms are usually caused by eating spicy, fatty or meat foods in combination with alcohol.
The pain syndrome manifests itself in the evening or at night. A sharp outbreak of pain and increased body temperature is caused by the formation of a subcutaneous focus of inflammation in the knee joint.
Laboratory tests will help accurately diagnose the disease. Using various tests, it is necessary to determine the daily rate of urine output from the body and the quantitative value of uric acid in the blood.
The level of uric acid in adult men should not exceed 420 µmol/l, in women - no more than 350 µmol/l.
For a qualitative diagnosis of gout, the kidneys and urinary tract are subject to ultrasound examination.
This procedure is necessary to monitor the condition of the organs and monitor the development of the disease.
First of all, successful treatment of the disease depends on strict adherence to a special diet. Products containing uric acid compounds should be completely excluded from the patient's daily diet. This measure guarantees a decrease in the level of uric acid in the blood.
Diet-based treatment completely eliminates the consumption of foods containing nitrogen and purine bases (brains, tongue, kidneys, liver). Lean meat is allowed in extremely small doses (200-300g per week).
All the patient's food should be fresh. The daily dose of salt intake should not exceed 5g. In no case should you fast, since hunger provokes the accumulation of uric acid in the body. With strict adherence to dietary rules, treatment of the disease will be successful.
In the initial stage of treating an illness, the main task of doctors is to eliminate pain and generally alleviate the patient’s condition. In case of acute pain, the patient is prescribed anti-inflammatory medications.
Treatment of gout is a rather long and systematic process. Complex therapeutic measures are carried out to stop the further development of the disease.
In rare cases, treatment leads to complete recovery. Immediately after stopping an acute attack of the disease, it is recommended to use a blockade injection. Treatment should be restorative in nature to the entire skeletal and muscular system of the body.
Colchicine will provide a tonic effect on muscle tissue and relieve acute inflammation. Non-steroidal drugs will help reduce inflammation in the knee joint: