What Is Gouty Arthritis
Gout is the most common term. But the correct medical term is gouty arthritis. As arthritis is the medical term for many diseases that cause inflamed joints.
So, I use the term gout mostly. Also, in my experience, most doctors do the same. Because it is shorter, more common, and most people recognize it as a medical condition that involves painful joints.
However, some people believe it is a dietary disorder. So it is good to use the term gouty arthritis. Because in that context, we can emphasize that gout is an arthritic condition that is mainly due to genetics. Bad diet can play a part. But much more common non-genetic factors include:
- Side effects of diuretic blood pressure pills.
- Other medicines and conditions.
- Environmental factors such as exposure to toxins.
I cover this in much more detail in the Gout Symptoms Section.
How Is Gout Diagnosed
In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed.
Since the treatment for gout is lifelong, its very important to make a definitive diagnosis. Ideally, the diagnosis is made by identifying uric acid crystals in joint fluid or in a mass of uric acid . These can be seen by putting a drop of fluid on a slide and examining it using a polarizing microscope, which takes advantage of the way uric acid crystals bend light. A non-rheumatologist, when possible, can remove fluid from the joint by aspirating it with a small needle and send it to a lab for analysis. A rheumatologist is likely to have a polarizing attachment on their microscope at their office. Gout crystals have a needle-like shape, and are either yellow or blue, depending on how they are arranged on the slide .
Figure 11: Uric Acid Crystals Under Polarizing Light Microscopy
There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting .2
Table 1: Diagnosing gout when no crystal identification is possible
Ideally, 6 of 10 features will be present of the following:
What Is The Difference Between Gout And Gout Flares
Date: 08/23/2018 | Topics :
More than 8 million Americans suffer with gout.1 But many dont know they have gout because they havent experienced gout flares. Its important to understand the difference between gout and gout flares.
Gout, a form of inflammatory arthritis, has been around since ancient times.2 The painful swelling and redness of gout flares often begins in the big toe.3 However, gout flares can occur in other body parts as well, such as the feet, ankles, knees, elbows, wrists and fingers.3
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Gout Vs Rheumatoid Arthritis
Rheumatoid arthritis, commonly abbreviated as RA, is an autoimmune disorder that causes inflammation. While RA primarily affects joints, inflammatory responses may also occur in the skin, heart, lungs, and other organs. Though some hypotheses exist, there is currently no known single cause for RA. Gout is a form of acute arthritis that has a known cause, namely the buildup crystalline uric acid deposits in the blood and joints. These crystals cause an inflammatory response, often in a big toe.
RA and gout can be very painful disorders, but gout tends to be more treatable and has a better prognosis in most cases. To diagnose the presence of either RA or gout, a physician must perform a series of diagnostic imaging tests. To differentiate between gout and pseudogout, fluid may also be drawn from inflamed joints for testing.
Gout And Osteoarthritis Characteristics
The difference between gout and arthritis starts with the cause. It becomes confusing to some people because the term gouty arthritis is often used to describe uric acid buildup in the joints. However, typical arthritis or osteoarthritis is normally caused by aging, injury, wear and tear, or it is a hereditary factor. On the other hand, it is uric acid crystals that cause gout, not aging or typical tissue wear and tear.
Doctors classify gout as a metabolic disease. This means that a set of risk factors may exist within a persons body that could make them more prone to the particular ailment. This is not always the case with osteoarthritis, since it can be due to normal wear in the joints. When a person gets osteoarthritis, they do not experience chills and mild fever like people with gout can.
Here are some other differences:
- Gout imaging tests, drawing fluid from the swollen joint for analysis, blood tests.
- Osteoarthritis x-ray, pain assessment, presence of deformity, evidence of muscle wasting, local inflammation, asymmetrical joints.
- Gout arthritic joint pain, swelling, redness, warmth, and extreme tenderness. Development of tophi possible. Acute onset more common.
- Osteoarthritis joints painful but without swelling, affects joints asymmetrically, affects bigger joints such as hips & knees.
Pattern of joints affected
Read Also: Does Arthritis Cause Muscle Cramps
Acute Attack Pain Management
Home remedies. Reducing inflammation during an acute gout attack will provide pain relief.
- Ice. Apply ice to the affected area to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice. Apply ice for about 20 minutes at a time.
- Elevate. Frequently raise and keep the affected area above the level of the heart.
- Rest. Move the affected area as little as possible while symptoms are present.
- Over-the-counter non-steroidal anti-inflammatory medicines. If the gout attack is mild, anti-inflammatory drugs available without a prescription may relieve pain. Because there are serious side effect of using non-steroidal anti-inflammatory drugs even the over-the-counter strength be sure to check with your doctor before taking them.
Prescription medications. Your doctor may recommend a prescription-strength non-steroidal anti-inflammatory medicine such as indomethacin.
Colchicine is also given to reduce inflammation during an acute gout attack. This drug has recently been approved by the Federal Drug Administration for treatment of gout. Like all medications, colchicine has side effects that you will need to discuss with your doctor.
Your doctor may also prescribe corticosteroids for acute gout attacks. These are strong anti-inflammatory medications that can be taken either in pill form, intravenously, or injected into the painful joint. Cortisone may improve the severe inflammation very quickly.
The Four Stages Of Gout
Gout is best understood by seeing it as having four phases or stages :
Stage 1: High uric acid
Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.
Stage 2: Acute flares
This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.
Stage 3: Intercritical periods
These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.
Stage 4: Advanced gout
This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .
Figure 1: Stages of Gout
Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the “bunion joint,” represent a gouty tophus.)
Figure 3: Progression of Gout
Symptoms Of Rheumatoid Arthritis And Gout
Because they are both forms of inflammatory arthritis, RA and gout share some of the same symptoms. Both can cause pain, inflammation and redness, swollen joints, and visible nodules . RA and gout can also cause stiffness in the affected joints, limiting the joints range of motion over time. These similarities may appear to make the two conditions indiscernible, but the location and onset of pain can help set them apart.
The Role Of Diet In Gout Prevention
Dietary control may be sufficient in a patient with mildly elevated uric acid, for example, 7.0 mg/dL
For those with a higher level, for example, 10.0 mg/dL, diet alone will not usually prevent gout. For the latter, even a very strict diet only reduces the blood uric acid by about 1 mg/dL- not enough, in general, to keep uric acid from precipitating in the joints. The cutoff where patients with gout seem to dramatically reduce their number of attacks is when their uric acid level is taken below 6.0 mg/dL.4
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Rheumatoid Arthritis Vs Gout: Causes And Risk Factors
Rheumatoid arthritis is an autoimmune disease, meaning, the bodys immune system attacks the joints wrongfully, setting off the symptoms associated with rheumatoid arthritis. Inflammation causes the synovium to thicken, which over time destroys the cartilage, allowing bones to rub together.
Risk factors for rheumatoid arthritis include being a female, being over the age of 40, having a family history of RA, smoking, being exposed to environmental pollutants, and being obese.
Gout is a result of crystallized uric acid, which occurs when a person has high levels of uric acid in their blood. Uric acid results from the breakdown of purines found in some foods like red meat and alcohol.
Normally, uric acid passes through our systems and is released through our urine, but with excessively high levels, the uric acid can build up and crystallize in joints and surrounding tissues, causing discomforting symptoms.
Risk factors for gout include eating a diet high in uric acid-promoting purines, being overweight or obese, having an untreated medical condition like hypertension, taking certain medications, having a family history of gout, being male over the age of 40, and recovering from a recent surgery or trauma.
Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
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Do You Have Arthritis Or Gout
If you have gout, that is a form of arthritis. But, it requires special gout treatment that may not be suitable for other forms of arthritis. So that is the essential difference between gout and arthritis. Because gout is a specialized form of arthritis. Therefore, you need specialist gout treatment that removes excess uric acid and stops gout returning.
If you have joint pains, you are an arthritis sufferer. But, you might doubt you have gout. So, you should read GoutPal Plan for Arthritis Sufferers next. Or, if you definitely have gout, read Questions for Gout Sufferers.
Leave Difference Between Gout and Gouty Arthritis to read What Is Gout.
Common Symptoms Of Rheumatoid Arthritis
Symmetrical symptoms: In RA, joint pain usually affects both sides of the body. Symptoms typically begin in the small joints in the hands and feet as the disease progresses, pain can develop in the wrists, knees, ankles, elbows, hips, and shoulders.
Morning stiffness: The pain of RA is typically at its worst in the morning, which causes a period of stiffness that can last an hour or longer. Motion helps ease RA symptoms, so people generally feel better later in the day as they accumulate more activity.
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What Is The Difference Between Gout And Gouty Arthritis
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Gout and pseudogout are sometimes mistaken for other joint conditions, such as: rheumatoid arthritis. osteoarthritis. carpal tunnel syndrome.
One may also ask, what is the difference between gout and uric acid? The body converts purines into uric acid. Gout can occur whenever there is too much uric acid in the blood. Uric acid is normally expelled in the urine, but high levels can form sharp crystals in the joints, causing inflammation and intense pain.
Regarding this, is gout an autoimmune disease?
Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks tissues, inflaming joints. In gout, the body produces too much uric acid or has problems flushing it out, and urate crystals build up in joints, causing inflammation and intense pain.
What kind of arthritis is gout?
Gout is a type of arthritis that happens when you have too much uric acid in your blood and it forms sharp crystals in one or more of your joints. This usually happens in your big toe, but you also can have gout in your knee, ankle, foot, hand, wrist, or elbow.
Differences Between Gout And Arthritis
Gout vs Arthritis
There are no major differences between gout and arthritis. Arthritis is considered to be the umbrella of these joint diseases. Under arthritis, it can either be classified as rheumatoid arthritis, gouty arthritis, or osteoarthritis. These are the most common forms and there are a hundred more.
Arthritis is the disease of the joints. The most common symptom is joint pain. In gouty arthritis, however, there is inflammation due to deposits of uric acid usually in the big toe. Gouty arthritis is also known as the Rich Mans disease because foods high in uric acid must be avoided, such as, red meat, red wine, green leafy vegetables, etc.
In order to diagnose what kind of arthritis you are experiencing, one may consult a rheumatologist or a doctor specializing in arthritis. The patient will undergo different kinds of assessment, mostly physical assessments. In gouty arthritis, the patient will undergo chemical blood tests to test for uric acid. If the result exceeds the normal value of uric acid which is circulating in the blood, then the doctor can confirm that it is gouty arthritis.
The cause of arthritis depends on the type or form of arthritis. If it is rheumatoid arthritis, then the cause can be due to direct or indirect viral and bacterial infections, autoimmune defects, trauma, or injury. In gouty arthritis, the cause is a metabolic abnormality.
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What Are The Signs And Symptoms Of Gout
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint may include:
- Pain, usually intense
Can Gout Flares Be Prevented
Yes. Colchicine is one of the most frequently used medicines for preventing the inflammation associated with gout flares.6 Originally derived from a plant called the autumn crocus , colchicine has been used to prevent gout flares in adults.2
Certain lifestyle modifications may also help reduce your risk of gout flares.7 These include drinking plenty of water, limiting or avoiding alcohol, limiting your intake of meat and certain kinds of fish and maintaining a healthy weight.7
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Difference Between Arthritis And Rheumatoid Arthritis
Arthritis vs Rheumatoid Arthritis
Arthritis is inflammation of joints. Arthritis is a blanket term which includes all types of arthritis like osteoarthritis, rheumatoid arthritis and gout. This article will discuss each type of arthritis in detail, highlighting their clinical features, symptoms, causes, investigation and diagnosis, prognosis, the course of treatment they require, and finally the differences between them.
Osteoarthritis is a very common joint condition. Women are more prone to symptomatic osteoarthritis than men. Females get it three times more commonly than males. It usually sets in around 50 years of age. Osteoarthritis occurs due to wear and tear. When it sets in spontaneously, without any previous joint disorders, it is called primary osteoarthritis. When it occurs as a result of another joint disease it is called secondary osteoarthritis. Joint injuries and diseases like hemochromatosis give rise to secondary osteoarthritis.
The x-rays of joints show loss of joint space, sclerosis under the joint cartilage, and marginal osteophytes. In some patients, CRP can be slightly elevated. Regular pain killers, anti-inflammatory drugs, low dose tricyclics, weight reduction, walking aids, supportive foot ware, physiotherapy, and joint replacement are a few treatment methods.
What is the difference between Osteoarthritis, Rheumatoid Arthritis, and Gout?
There are no osteophytes in rheumatoid arthritis.
Rheumatoid Arthritis And Gout Comorbidities
Individuals with rheumatoid arthritis have a higher prevalence of cardiovascular disease, infections, mental health conditions, and malignancies such as leukemia or multiple myeloma.
Gout, on the other hand, has been associated with kidney stones and kidney disease , diabetes, sleep apnea, cardiovascular disease, and cancer. Many of gout comorbidities are due to the fact that they share similar risk factors. For example, in both sleep apnea and gout, obesity is a common risk factor, the same can be said for diabetes.
Read Also: How To Decrease Arthritis Inflammation
What Can Trigger A Gout Attack
Several things can cause the crystals to shake loose into your joint cavity, triggering an attack. These include:
- a knock or injury to the joint
- an illness that may make you feverish
- having an operation
- having an unusually large meal, especially a fatty meal
- drinking too much alcohol
- starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.
How Can I Manage My Gout And Improve My Quality Of Life
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
For gout in particular:
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.