Gout is a syndrome resulting from the deposition in and around joints of crystals composed of a substance called uric acid (monosodium urate crystals). Uric acid is the end product of the metabolism of a food component called purine. Increased levels of uric acid (hyperuricemia) is a result of either over-production or under-excretion of the substance.
Acute gout typically presents with pain, swelling, warmth and redness in a joint. Usually the first attack affects only one joint. Commonly affected is the large joint at the base of the big toe (podagra). Other joints commonly involved are the ankle, knee, instep or forefoot, wrist and fingers, elbows, and even the spine.
Acute attacks commonly start during the night and usually peak within one to two days of symptoms onset. Untreated attacks may last seven to 10 days.
Treatment goals include termination of the acute attack, prevention of recurrent attacks and prevention of complications (especially kidney disease) associated with the deposition of urate crystals in tissues. Treatment of associated features such as obesity, alcohol use, hypertension, and elevated cholesterol levels also figures prominently in the overall plan.
This MediFocus Guide contains an extensive listing of citations and abstracts of recent journal articles that have been published about this condition in trustworthy medical journals. This is the same type of information that is available to physicians and other health care professionals. A partial selection of journal articles that are abstracted in this MediFocus Guide includes:
Clinical manifestations of gout and their management. Medical Journal of Australia. 2000
Gout update: from lab to the clinic and back. Current Opinion in Rheumatology. 2000
Renal transplant-associated hyperuricemia and gout. Journal of the American Society of Nephrology. 2000
How well have diagnostic tests and therapies for gout been evaluated?. Current Opinion in Rheumatology. 1999
Kienbock's disease and gout. Journal of Hand Surgery - British Volume. 1999
Diagnosis and management of gout. American Family Physician. 1999
Gout and hyperuricemia. American Family Physician. 1999
Reappraisal of the pathogenesis and consequences of hyperuricemia in hypertension, cardiovascular disease, and renal disease. American Journal of Kidney Diseases. 1999
Care of the patient with gout. Geriatric Nursing. 1999
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