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Symptoms of gout in men and women
Last reviewed: 23.04.2024
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Gout is a disease that restricts a person in movement and causes him to experience wild pain in the legs. For example, because of gout attacks, the famous military leader Kutuzov could not sit on a horse without the help of soldiers. What are the symptoms of gout and how to fight this disease?
What is gout?
In short, it is a disease that takes a person in their claws because of a metabolic disorder. Namely - the exchange of purines in the body is broken - the substances that participate in the creation of DNA. And instead of them, uric acid accumulates, which causes wild pain in the limbs.
All these troubles are combined with attacks of arthritis in acute form, as well as the accumulation of urate (this is a salt of uric acid). That's why a person is very limited in movement and has pain in the limbs. That's why Kutuzov can not climb the horse.
What is tofusi?
Tofuses are knots in compositions that are hard to feel and which are visible to the naked eye. Tofusi are classic symptoms of gout when it passes into a chronic form. These nodes appear when a person is sick with gout more than 5 years.
What do tofuys consist of? From the connective tissue that surrounds the frozen urate stones. Nodules are obtained. They can be located not only on the hands and feet, but also on the elbows, the shells of the ears, on the soles, on the hips, forearms, legs and even in the nose - its cartilaginous septum.
These nodules are yellow, they are immediately visible in areas affected by gout. During pain attacks, tofus may not be so hard, they are diluted, the liquid is released through small holes in the skin - fistulas. The only plus of these small nodules is that infection can not get into them, since urate itself is bactericidal, has antibacterial properties. What is excreted through fistulas is intense white.
Causes of gout
If gout is identified as primary, the cause may be genetic changes - primarily - defects in protein molecules, or enzymes that take a direct and active part in the metabolism. Speaking even more accurately - without these molecules (enzymes, enzymes), the metabolism could not normally occur. Protein molecules, first of all, accelerate the chemical processes in the body.
At a primary gout it is quite often found out genetically caused defects in the enzymes participating in a metabolism
The genetic defect is also associated with hypofunction of renal enzyme systems regulating the excretion of uric acid. The development of gout is also facilitated by excessive nutrition, monotonous meat, the consumption of alcoholic beverages (especially beer, dry grape wines), and a sedentary lifestyle. The most common cause of secondary gout is kidney disease with kidney failure, blood diseases (polycythemia, leukemia), accompanied by cell decay and hyperuricemia.
Risk groups
This is mostly men after 40 years. And if a person turns 50, the risk of gout develops 2-3 times. Why do men love gout most of all? According to one theory, the occurrence of this disease is associated with a defect of the male chromosome. Therefore, the strong sex suffers most from the manifestations of gout. Men suffer from this disease 20 times more often than the fairer sex.
Gout is also associated with poor kidney function. Then this disease is classified as kidney gout. That is, in the risk group - people with impaired renal function. The connection of the kidneys to the gouty condition does not need to be searched for long - the kidneys are not able to purify the blood of protein products, so the blood flow slows down, there is a risk of depletion of body tissues with beneficial substances, and these tissues can get sick.
In addition, in the blood, which is poorly purified, the level of uric acid increases - such small, seemingly innocent crystals. But these crystals are actually dangerous for humans, because they are able to make joints narrower in diameter. This means that the joints can no longer perform their work qualitatively and signal this with pain, exhausting, long, unbearable. To pain join also inflammation of the joints, as well as the muscles that are located around them. Then the inflammatory processes in the body are accompanied also by swelling.
People whose kidneys do not work well should pay attention to the condition of their joints - then gout can be stopped in its early stages, when the disease is not so insidious.
Gout associated with kidney disease
Gout attacks can be combined with kidney stones, causing pain in the joints and kidneys to increase. Such pains are very frequent, they occur in 40% of patients. Kidney stones and manifestations of gout may be aggravated by pyelonephritis.
Gout may be aggravated by another rather terrible disease - gouty nephropathy. This is the state of the kidneys, when the kidneys can not perform their functions. To this condition, kidney failure may be associated. An indicative symptom may also be increased blood pressure, causing patients to experience severe headaches, such patients about a third.
Seven stages of gout
Gout is manifested in 7 stages. Each of these stages has its own beginning, its course and its character of pain. It is important for a person to know what happens to him when he has gout symptoms.
Acute classic gout attack
Why classic? Because these symptoms are characteristic of manifestations of gout. They occur in 70-80% of cases. Most often, seizures overtake a person in the middle of the night. A person begins to feel weakness in the legs, hands, it shivers, he can not walk around the kitchen to drink a glass of water. In addition, severe headaches, arthralgia, subfebrile condition are possible.
The indicator that a person has gout in its classical manifestation will be a sharp pain in the joint of the metatarsal phalanx, which concentrates in the big toe. This joint swells very quickly, it can also be distinguished by red skin, then the skin changes its shade to bluish-red, with the skin glistening and firm touching.
The finger is hot at this time, it hurts to touch it. Of course, in this state the finger is very difficult to move - it freezes in one position, it is not possible to wear shoes at all.
The human body temperature rises to 39 degrees, it fever. These are the manifestations of classical gout.
What causes pain?
Food with high fat content, alcohol overdose (severe intoxication), injuries of any parts of the body, especially lower limbs.
Duration of pain and attacks
Three to ten days. Then the pain subsides temporarily and can resume after a while - a month, two, three, sometimes in a year or two. At a time when the pain subsides, disappear and swelling, the joint begins to work normally, the movements can be done with the same ease.
What happens in the body during an attack?
First of all, the inflammatory process in the body is underway, which means that blood is necessarily reacting to it - our vital fluid. So, when analyzing blood, doctors detect an elevated level of ESR, acids of sialin, seromucoid, fibrin, and also identify C-reactive protein, which should not be in a healthy state. C-reactive protein is a protein that appears in the blood, as soon as inflammatory processes are detected in the body.
Attack of gout in men and women
If the attack of gout passes for the first time, then men may have additional symptoms, characteristic of arthritis. The joint of the big toe hurts, it swells, the metatarsophalangeal joints, and tarsus suffer the same way.
Inflammation and ulnar joints can also be inflamed, but this is not a frequent manifestation of gout. It is very rare that the joints of the pelvis, hips, shoulders, chest, and also the collarbone can become inflamed and hurt.
But all these manifestations in men - manifestations of monoarthritis, that is, it inflames and hurts any one part of the body of the above.
As for women, their doctor can establish polyarthritis - that is, multiple joint diseases of different parts of the body. Basically, these are hands (up to a third of women suffer from these pains!), As well as diseases and swelling of the ankle joint, metatarsus, knees, wrist joint.
For these symptoms, men and women can determine that they have gout, not injury to the joints or something else.
Subacute stage of gout manifestations
It manifests itself as a monoarthritis (that is, the disease of a single joint). The joint of the big toe usually suffers most. True, the pain is minor. Perhaps swelling and pain in the middle or large joint of the legs or arms, this is more typical of young people under 30 years of age.
Rheumatoid variant of gout
His symptoms - the defeat of the joints of the hands, the smallest, or the manifestations of monoarthritis, manifestations of leigoarthritis, or painful attacks in the joints, which can last several hours or even a day.
Pseudophlegonous stage of gout
It is expressed as a mono-manifestation of arthritis. It can be localized in any joint and tissues that surround it. High temperature - from 38 degrees - is also an expressive sign that a person has a pseudo-refluxing stage of gout. In addition, the accompanying symptoms are associated symptoms: a pronounced inflammation of one joint, fever, an increase in ESR in the blood, leukocytosis.
Gout by type of allergic infectious polyarthritis
This type of gout can bother a person in 5% of cases. That is, it is quite a rare form of it. Gout by the type of allergic infectious polyarthritis can manifest itself as a polyarthritis, but the localization of pain is not constant, but nomadic. Inflammation with this kind of gout manifests itself very quickly, the inflamed joints are shiny and hard to touch, can be an intimidating purple hue.
Gout in the low-symptom stage
With this type of gout, the pain can hardly be felt, the inflamed joint is of little concern, and the person often suffers without going to the doctor. This is not allowed in any case, you need to see a doctor even if the pain is not very strong. This form of gout can also be distinguished by skin hyperemia in the area where the joint has become inflamed.
Gout in the arthritic form
This disease presupposes a pain that is localized in the tendons, most often in the calcaneal tendon. It is dense touch and thickened. With every hour and day, if this form of gout is not treated, chronic polyarthritis develops with gouty implication.
With this form of gout, the joints of the legs suffer most, they are deformed. A person can no longer move as before, his movements are hampered by severe joint pains. And their deformation is due to deposits in joints resembling nodules. Also, bone growths are possible, the fingers are very easy to dislocate, they are not so mobile, they can hear a crunch.
Patients with this form of gout are very poorly moving, they can not fully work. Together with the joints, muscles are deformed, they are no longer so strong, they do not support the joints badly. True, with frequent contracture of muscles ankylosis (complete immobility of the joints) occurs quite rarely.
With this form of gout, people should remember that they can have sharp pain attacks, then these pains become chronic, as well as inflammation of nearby muscle tissue. This is due to the constant influx of urates - urine salts (in Greek, "urate" - urine).
Two forms of gout
There is a primary gout, and there is a secondary one. In the first case, this disease does not arise because of some other diseases, it is as if by itself (although everything in the human body is interrelated). In the second case - secondary gout - the culprits of the disease are other ailments: psoriasis, myeloid leukemia, congenital heart disease, hemoglobinopathy and other diseases of internal organs and blood. To secondary gout is also its form, when a person uses certain medications that affect the tissues of the body: cytostatics, drugs with riboxin, saouuretics and other medications.
Who to contact?
What examinations are done with gout?
The general analysis of a blood - on it can define, whether there are inflammatory processes in an organism; In addition, with gout in the blood will be increased ESR.
Blood analysis for biochemistry - when gout is determined by increasing levels of sialic acids, haptoglobin, Y-globulins, alpha-2, as well as fibrin, uric acid. Elevated blood levels of uric acid will be more than 0.12-0.24 mmol / l.
Radiography of all joints - this method helps to determine if a person has a chronic form of gout. If so, white spots with a value of 0.5 mm to 3 cm in diameter will be visible on the screen. All these changes in the joints are due to tofus, of which you are already well aware.
Tofuses can be large, and then, destroying, they destroy the cortical substance of the joints. This phenomenon is called a symptom of bloating of the bone edge. When gout worries a person for a very long time, the gland of internal secretion, which is called the pineal body, can collapse almost completely. Instead of it salts of uric acid in a solid form - urates are formed. They can be seen on fluoroscopy, but not in the initial stage, and not less than five years after the person became ill with gout.
Synovial fluid analysis
Normally, the number of leukocytes should be from 1 to 15 × 109 / l. Its color should be transparent, the synovial fluid should not be viscous. If a person has gout in a chronic form, the crystalline salts of uric acid are clearly visible in the synovial fluid.
Biopsy of puncture of tophi
This method is used to find uric acid crystals in tofus. Then you can accurately determine what a person has gout.
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