An expedition into the world of gout

Gout is a disease that remains undiscovered for a long time and suddenly it starts with a bang, namely an acute gout attack. Usually, the base joint of the big toe is inflammated. In the bible you find the famouspericope of the sick of the palsy, who was taken down on his bed into the house to Jesus, after his bearers had taken off a part of the roof. It is thought that the palsy was due to gout.

Gout is the result of a metabolic disorder. Humans excrete uric acid only much worse than birds for instance. A genetic metabolic disorder, which even leads more to a degradation uric acid excretion, often worsens the situation. If it comes to an increased intake of purines, the raw material for uric acid, then there will be an increase of uric acid in the blood (hyperuricemia) and afterwards in the tissues is due to first.

The cartilage of the joints stores uric acid; because of the concentration gradient uric acid crystals will be released into the synovial fluid later, causing infklammation. High inflammation is associated with very strong pain. A gout patient once said in an interview: "I´d rather go to hell, than enduring this pain any longer."
Gout is acute, the attack comes out of a sudden. Reduced fluid intake combined with physical effort often precede an attack. The pain is described as burning, pungent, throbbing. Hyperthermia and redness of the joint are common. It is reported that the Blanket on the toe can not be tolerated because of pain.
You can secure the diagnosis by a few drops of synovial fluid, because under the polarized light microscope, you can clearly see the gout crystals.
Apart from the joints uric acid can also accumulate under the skin and so called tophus which can be seenparticularly well at the ears.
An elevated uric acid levels endangers not only the joints but also internal organs such as the kidneys and the heart. Chronic uric acid increase also leads to a faster development of arthritis.
Gout can and must be treated with a great emphasis on the change of lifestyle.

(may be be continued)

More on gout:
Gicht / Gout / monströse Harnsäure-Depots / subcutaneous depots of uric acid http://twitpic.com/4q61mh 

http://rheumatologe.blogspot.com/2011/11/hyperuricemia-and-gout.html 

And a newer one, in fact the most recent one: http://rheumatologe.blogspot.de/2014/02/a-new-venture-into-world-of-gout.html