Physicians diagnose gout when they see someone who has the classic presentation of intermittent flares of their joints in the setting of high blood uric acid. Although the blood uric acid is not always elevated during an acute flare it is almost always elevated between flares. A definitive diagnosis can be made when fluid is aspirated from the joint and it shows the colorful needle-shaped crystals of uric acid.
Treatment of gout involves two different approaches:
- Treating the inflammation
- Preventing flares by lowering the uric acid.
Treating flares of gout can be done with nonsteroidal anti-inflammatory agents, colchicine, and corticosteroids. Treatment of flares usually works best if started as soon as possible after an attack begins. Gout can be prevented with medications like allopurinol, febuxostat, and probenecid. These medications lower uric acid quickly but it will usually take months to completely prevent flares. Restricting foods high in purine is also important in controlling blood levels of uric acid. These include foods like seafood, organ meat and beer.
Although gout can be an extremely painful disease it also is one of the most treatable diseases. With careful attention to diet and strict compliance to medications most patients can lead normal active lives.
At Arizona Arthritis and Rheumatology Associates we help patients control their gout with dietary and medical management. Our research arm of the practice Arizona Arthritis and Rheumatology Research (AARR) helps develop new medications to advance the treatment and prevention of gout.
By Dr. Eric Peters, MD, Rheumatologist