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Is It Gout or Something Else?


Those who aren't familiar with all the conditions that can affect the foot, will often think that foot pain can be the result of gout. However, there are many different conditions that can cause foot pain. Some of these conditions can also mimic the symptoms of gout.


What is Gout?

Gout results from a build-up of uric acid in the tissues or a joint. The joint that is most often affected is big toe joint. Gout is an extremely painful condition. It usually begins with an intense pain that comes on suddenly, often in the middle of the night or when you wake up. There is redness, swelling, and warmth over the affected joint.


What Causes Gout?

Gout attacks are caused by deposits of crystallized uric acid in the joint. Uric acid is present in our blood as we break down purines, chemicals that are found in our bodies and food. We eliminate uric acid in our urine. Those who have gout, either because their kidneys have difficulty eliminating normal amounts of uric acid, or they produce too much uric acid.


Why Does Gout Like the Big Toe?

Uric acid is sensitive to temperature changes. At cool temperatures, uric acid turns into crystals. The big to is the part of the body that is furthest from the heart, and the coolest part of the body, making it an ideal target for gout.

The Gout (James Gillray, 1799) depicts the pain of the artist's gout as a demon or dragon.

How is Gout Diagnosed?

The diagnosis of gout includes learning about personal and family history, examining the affected area. Blood labs are often obtained assessing uric acid and inflammatory markers. Blood work will also be helpful in ruling out other conditions, such as infection. X-rays and ultrasound can also be helpful in determining if the patient is suffering from gout or another condition


What Other Conditions Can Be Confused With Gout?

Primarily, the location of the pain is helpful in making the diagnosis. A red, hot, swollen joint can also be caused by an infection, or a flare of arthritis. Redness and swelling of the foot an be caused cellulitis, stress fracture, or a serious condition called Charcot Neuroarthropathy.


How is Gout Treated?

Initial treatment of gout typically includes medications to help treat the pain, swelling, and inflammation. Drink plenty of water and other fluids, while avoiding alcoholic beverages. Also foods and drinks that are high in purines should be avoided. These include shellfish, organ meats (kidney, liver, etc.), red wine, red meat, and beer. Avoid standing and walking to rest your foot. Elevating the foot can also help with the swelling. The symptoms usually resolve in 3-10 days with treatment.


Gout treatment may involve taking a daily medication for maintenance treatment. In cases of repeated episodes, the underlying reason for the gout must be addressed. The build up of uric acid over time can can damage to the joint.


If you feel as though you are suffering from gout or you are having a gout attack, please contact our office and we will have on our providers evaluate you.

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