Tophi in gout: pictures, causes and treatment of this disease
Gout is called the disease of the joints. The reason for its development is the increased level of uric acid in the body.
The symptoms of the disease
The first signs of disease develop acute attacks of gouty arthritis, which occasionally make themselves felt. In the process of development of the disease the formation of nodules known as tophi in gout. During attacks of gouty arthritis, the patient can rise the body temperature. As a rule, after carrying out certain tests and diagnosis, the doctor will prescribe an individual treatment, because further action depends on the cause and stage of the disease.
As has been said, appears for the first time gout attack of gouty arthritis. It often occurs after excessive consumption of meat or alcohol. The pain characterized as crushing, very strong, mainly occur in the night or evening hours. In most cases, gout affects the joint of the big toe. Less often it can be elbow, knee and other joints.
In the area of the affected joint, occasionally there is intolerable pain, often possible to observe swelling and redness. The mobility of the affected limb can significantly intensify pain. The affected joint, it is first necessary to ensure maximum rest. Further, it is very important to immediately consult a doctor.
After the tests will show the levels of uric acid in the patient’s body, revealed the cause of the disease, and then treatment.
The causes of gout
Most often gout occurs in men. Women in most cases, this disease occurs after age 50, when the level of estrogens (female sex hormones) is significantly reduced. As you know, estrogen, when they normally, have a positive effect on metabolism. Consequently, their loss causes the body metabolic disorders and, consequently, a tendency to gout.
Gout is often seen in people who abuse alcohol, and those who suffer from overweight. In addition, gout is hereditary. People with a genetic predisposition to the disease, will be automatically included in the risk group.
Due to the fact that gout is a consequence of disturbed metabolism, increased uric acid levels due to two main factors: the kidneys are unable for some reason to bring a normal amount of uric acid from the body or increased its content, which even healthy kidneys are not able to cope. This can lead to kidney stones. Consequently, the patient’s medical history in one way or another connected with the work of the kidneys.
ICD 10 — international classification of diseases No. 10. Code for gout, ICD-10 — M10, which refers to a microcrystalline type of arthritis. The reason is violation of function of kidneys.
In turn, ICD 10, gout is divided thus:
- code M10.0 — idiopathic;
- code M10.1 — lead;
- code M10.2 — a drug;
- code M10.3 — gout related to impaired renal function;
- code M10.4 — secondary;
- code M10.9 — unspecified.
Thus, elevated levels of uric acid can often be associated with kidney problems. Related kidney disease reduces the function of filtering, which leads to a gradual deposition of crystals index of urate in the body. As a rule, more likely to suffer joint: blood supply is not there that allows the index of urate crystals to gain a foothold. In addition, gout may occur due to hypertension, and can cause disease of certain groups of medicines, the reception of which is required in the treatment of many serious diseases.
What are tophi
Inflammation of the affected joint, accompanied by unbearable pain is characterized as an acute attack of the disease. If the disease is left untreated, the process continues and the formation of nodules, called tophi. Tophi indicate that the disease managed to get the chronic form. Their appearance is due to excess amount of uric acid in the body, deposits of which often can be noticed in the elbow joints, in heels, in the cartilage of the auricles. Accumulated salt crystals gradually form nodules. They have a white or yellowish color and is well palpated through the skin.
Serious harm to the body tophi do not cause. Their appearance only suggests that in a patient broken metabolism and gout has become chronic. Tophi painless but when they occur require increased treatment of the disease. Gout this is especially necessary because the disease most often develops from an acute into a chronic form and cause the patient pain. The use of drugs gradually relieves acute symptoms of the attack, but in order for aggravation was not repeated, it is required to strictly comply with all doctor’s orders.
The treatment of the disease
Gout treatment is divided into two main stages:
- measures to stop the attack of the disease;
- the steps for the normalization of metabolism.
Due to the fact that gout primarily occurs an attack of gouty arthritis, which is accompanied by intolerable pain, treatment in most cases is carried out in a hospital. Undertake all required tests, a comprehensive diagnosis, identify the causes of the disease. The tests are necessary in order to identify the nature of the disease (reactive or infectious). After accurate diagnosis, re-hospitalization is not required.
When all was tested, for the removal of a gouty attack, doctors prescribe nonsteroidal anti-inflammatory drugs (NPRC). Such drugs include ibuprofen, naproxen, etc. using these tools, you can not only take a strong pain but to halt the inflammatory process in the affected joint. A comprehensive treatment of an acute attack with the use of anti-inflammatory drugs designated doctor, they also define the required dosage.
For full treatment of gout insufficient use of nonsteroidal anti-inflammatory drugs. They can be used only to relieve symptoms of acute gouty attack.
The drug colchicine is aimed at reducing the inflammation process during an acute gouty attack. The use of colchicine relieves pain and gradually restores the function of the affected joint. The use of the drug must appoint a physician as necessary to take it under a special scheme.
If the use of colchicine has not given the desired result, the patient is prescribed hormonal drugs (corticosteroids), which are able to suppress the inflammatory process in the affected joint. Injections (betamethasone or methylprednisolone) produced in the affected joint. With the help of these drugs, doctors suppress the symptoms of acute gout attack for 1-2 days. Further measures are the primary treatment of the disease, to restore normal metabolism in the body.
Given the fact that the disease is directly related to metabolic disorders and the cause is an increased amount of urate, the main goal of treatment is lowering of their content in the body of the patient. On this basis, the patient is assigned drugs that can reduce the level of uric acid. One of these drugs is allopurinol. In addition, the patient requires drugs that contribute to increasing the excretion of uric acid from the body.
Correct and timely action can reduce the frequency of attacks of gout. To treat the disease alone is not recommended, because, first of all, you need to pass certain tests and to ensure that the kidneys healthy.
The use of diet with gout
With the development of gout is very important to follow the diet of the patient. There are a number of foods that contain high amounts of purines, and to use such food should be moderate portions. With the help of diet and medication prescribed by the attending physician after the first attack, you can prevent further progression of the disease. However, it should be noted that the list of unwanted products is quite extensive. But considering the consequences of the disease, I’m sure many patients would prefer to follow a diet.
A list of products that are not recommended to use in gout:
- oily fish;
- the liver (and other offal);
- bean products;
- salty and spicy foods;
- alcoholic beverages (beer, cognac, wine).
To avoid the development of disease, it is very important to monitor their diet and not to abuse the junk food. At the first symptoms of gout you must immediately consult a doctor. Otherwise, the disease may acquire a chronic form, and complications of gout are very dangerous.