GOUT

Definition
In gout, monosodium urate crystals are deposited in tissue, causing inflammation and severe pain of relatively rapid onset, usually in a single joint. It occurs in three to four out of 1,000 persons, and 90% to 95% of patients are men over age 30. One in four have a family history of gout. Once called “the rich man's disease” because of its association with overindulgence
in food and alcohol, this metabolic disorder can be exacerbated by poor diet. Primary gout is the result of overproduction or under excretion of uric acid. Secondary gout is the result of myeloproliferative diseases, lead poisoning, enzyme deficiencies, or renal failure. Left untreated, gout may lead to a chronic arthritis.

Risk Factors
Major causative factors and risk factors that can contribute to the incidence of gout include the following:
• Diet high in purine-containing foods
• Family history of gout
• Obesity
• Hypertension
• Stress resulting from a fracture or surgical procedure
• Use of thiazide diuretics
• Drinking alcohol
• Polynesian heritage
• Diabetes
• Renal failure

Symptoms & Signs
Common signs and symptoms of gout include:
• Pain in a single joint, often at the base of the great toe, but can be in other joints of the feet, fingers, wrists, elbows, knees, and ankles
• "Exquisite" pain and tenderness
• Swelling, heat, and stiffness of joint
• Shiny red or purple coloration of joint
• Fever up to 39°C (102.2°F) with or without chills Begins in hours and may subside over a few days or up to three weeks.
• Untreated, attacks will be more frequent and more severe