Gout is a type of arthritis that occurs owing to deposition of uric acid crystals in the joints. Although it can affect the knees, ankles, wrists and hands, the big toe joint at the base is primarily the site of gout attack. Elevated uric acid level in the blood increases the risk of gout. Uric acid is a byproduct of metabolism of purine, a substance that occurs naturally in several foods, especially those rich in protein. Normally, uric acid is flushed out of the body through urine.
However, in certain circumstances, the kidneys cannot excrete sufficient amount of uric acid that boosts the uric acid level in the blood. When there is too much uric acid in the blood, the excess uric acid may accumulate in the joints and crystallize into urate. The insoluble needle-like crystals cause pain and inflammation in the joints. Gout is primarily divided into two categories – acute gout and chronic gout.
Types Of Gout
Acute gout is the most common form of gout. It is characterized by sudden pain and inflammation of the joint. It may affect the large joint of the big toe or multiple joints simultaneously. The gout attack usually starts suddenly in the night. Most people susceptible to gout are woken up in the middle of the night by severe pain in the big toe, ankle or heel. At the early stage of gout, the gout flare-up usually subsides within a few days.
However, with progression of the condition, you may experience frequent gout flare-ups. With appropriate treatment, it takes about 3 to 10 days to reduce pain, swelling and redness of the affected joints. The duration and severity of the symptoms of acute gout attack tend to increase over time. With proper treatment and dietary modifications, you can prevent acute gout flare-ups.
Chronic Gout or Tophaceous Gout
In some cases, the symptoms of gout refuse to subside. The pain lingers for weeks and even months. Persistent pain, swelling and redness in the joints affected by gout are symptoms of chronic gout.
Also known as tophaceous gout, this severe form of gout occurs at the advanced stage when the urate crystals collect in the soft tissues in addition to the hard tissues. Apart from the big toes, elbows and fingers, the uric acid crystals in tophaceous gout may be found in the vocal cords, ears or spinal cord. About 10 percent of all gout patients suffer from chronic gout.
Depending upon the reason for increase in uric acid level in the blood, gout is categorized as primary gout and secondary gout. Rise in the uric acid level due to hormonal, genetic or dietary factors is known as primary gout. However, in a large number of cases, the exact cause of hyperuricemia is unknown. This form of primary gout is also known as idiopathic gout.
Side effects of certain medications and health conditions may cause gout. This form of gout is known as secondary gout.
Medicines associated with gout attack include low dose aspirin, diuretics, levodopa and cyclosporine. Thyroid problems may also trigger gout attacks.
Unlike true gout that occurs due to deposition of uric acid crystals in the joints, pseudo-gout occurs when calcium pyrophosphate crystals accumulate in the joints. The symptoms of pseudo gout are same as that of true gout. Hence, it is known as pseudo gout or false gout. In some cases pseudo gout occurs along with true gout.