Footnotes / Blog

“when i doubt..it’s gout” is my motto

Gout can be one of the most easily missed diagnosis’s. As you may or may not know, gout is a painful inflammatory joint condition. While its most commonly found in the big toe joint followed, it can occur anywhere.

When patients ask me what gout is I usually compare it to diabetes. In diabetes, patients have problems processing sugar. In gout, patients have problems processing protein. Thankfully gout isn’t fraught with the long term complications associated with high blood sugars, but can nonetheless be very painful debilitating disorder.

Specifically, the pain and inflammation associated w/ gout is caused by Uric Acid (a by product of protein metabolism). Without boring you to death with the biochemistry behind the disorder, in short the Uric Acid crystals precipitate near a joint causes a red hot swollen joint. The reason the big toe is the most common is because its easier for uric acid to precipitate out in a cool environment, and naturally your big toe is a lot colder than your hip.

Treatment varies from patient to patient. It usually starts w/ diet modification and limiting protein and alcohol intake. In fact they used to call it “rich man’s disease” back in 1700’s because only rich people could afford to eat meat and drink alcohol, hence would be the only people that would suffer from this disorder.

Other treatments include reducing the inflammation with Colchicine, Indomethacin or a cortisone shot. Then for prophylaxis patients can be placed on either Probencid or Allupurinol to prevent this sort of thing from reoccurring.