Gout and Gouty Arthritis
Gout is often related to an inherited abnormality in the body's ability to process uric acid. This lack of processing of uric acid, leads to an accumulation of uric acid in the body, called hyperuricemia. Many people have elevated levels of uric acid in the body without any significant adverse effects, however it is considered a precursor to the development of gout. Often times the excess uric acid leads to the formation of tiny crystals of urate which then deposit in various tissues of the body, causing kidney stones, kidney function impairment and/or failure, and gouty arthritis, as a result of the inflammation within the joint space caused by the crystalline deposits. When enough uric acid crystal deposits and a patient will experience a gout attack, a very painful, sudden inflammation of a joint space associated with swelling, stiffness and redness. The joint most often affected is the big toe, followed by the knee, ankle, foot, wrists, fingers, and elbows.
Gout is considered a chronic, progressive, and destructive disease, which can cause tophi or lumps of uric acid crystal deposits permanently beneath the skin and leaving permanent deformities to the joints. It affects men nine times more than women, and often precipitated by the overconsumption of foods high in purine, such as beer, alcohol, red fatty meats or fishes, carbohydrates and sweets. Additional triggers include dehydration or infections. Some medications, such as water pills or diuretics, can also cause hyperuricemia and eventually gout. Proper diet, increased water, and a possible addition of a uric acid controlling medication can prevent further progression.
Pseudogout, also known as Calcium Pyrophosphate dehydrogenase crystal deposition disease, is the condition which can sometimes be confused with gouty arthritis because it produces similar symptoms. However, in CPPD deposition disease, deposits are made up of calcium phosphate crystals, not uric acid. The signs and symptoms, and presentation of the patient are similar in the sense that the joint becomes inflamed, painful, swollen and stiff, though the progression is more gradual than insidious.