Spring 2024 5 GOUT: Don’t underestimate it! Living with gout People who have chronic kidney disease, high blood pressure or heart disease are at higher risk for gout and should not ignore symptoms of localized joint pain or joint swelling. These patients also should avoid oral nonsteroidal anti-inflammatory drugs to treat joint pain because of the negative effect these drugs can have on their kidney function or blood pressure. If you think you may have gouty arthritis, it is important to pursue an accurate diagnosis and be sure you are receiving the appropriate long-term treatment to prevent irreversible joint damage over time. How is it treated? There are two important parts to treating gout. The first is aimed at quickly and completely resolving the acute attack when it occurs. Treating an acute flare typically involves receiving a small dose of medication injected into the joint or taking a course of oral medication to help calm the inflammation down. The second part is initiating a once-daily medication to lower the amount of uric acid in the body, thus limiting or ideally stopping future gout flares altogether. In addition to prescribing medication, I address lifestyle changes and dietary recommendations that can help manage gout. Diagnosing gout As a rheumatologist, I have special training in diagnosing and treating arthritis and other diseases that affect the joints, muscles and bones, including certain inflammatory and autoimmune diseases. Diagnosing gout ideally includes aspirating the affected joint with a small needle, then viewing the fluid under a microscope. If urate crystals are observed, then the diagnosis is confirmed and an accurate treatment plan can ensue. While a blood test to measure the amount of uric acid in the body is helpful information, it is not enough on its own to confirm or rule out a gout diagnosis. By Leann Bassing, MD, board-certified in rheumatology and internal medicine; Yankton Medical Clinic, P.C. Gout is a type of inflammatory arthritis that affects over 9 million people in the U.S. It is something I see often in my rheumatology practice. When treated correctly, gout can be extremely well-controlled and permanent joint damage can be avoided. However, when ignored or treated inadequately, patients with gout can develop permanent, and sometimes very severe, joint damage over time. What are the signs and symptoms of gout? The most common presentation of gouty arthritis is that of sudden and intense pain and swelling in one or two joints. Small joints, like toes and fingers, are a typical location, but larger joints, such as knees and elbows, can be involved too. Severe attacks of joint pain are often followed by periods of time with no symptoms. When gouty arthritis lingers, the urate crystals that develop from excess uric acid in the body can also form lumps or swollen growths under the skin. These are called tophi. Avoid painful attacks If you are experiencing recurrent gout flares, please reach out for an appointment: 605-665-1722.
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