An expedition into the world of gout

"I am the god of hell fire and I bring you:

Fire, I'll take you to burn."

Arthur Brown "Fire"

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 famous pericope about 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 joints’ cartilage stores uric acid; because of the concentration gradient uric acid crystals will be released into the synovial fluid later, causing inflammation. High inflammation is associated with very strong pain. A gout patient once said in an interview: "I´d rather go to hell, than endure 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 a blanket on the toe cannot 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 joints uric acid can also accumulate under the skin and the so called tophus can be seen particularly well at the ears.
An elevated uric acid endangers not only the joints but also internal organs such as the kidneys and the heart. Chronically increased uric acid also leads to a faster development of osteoarthritis.
Gout can and must be treated with a great emphasis on 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: http://rheumatologe.blogspot.de/2014/02/a-new-venture-into-world-of-gout.html