If you have experienced severe pain and severe inflammation in a joint, but have not suffered an injury and do not suffer from any medical condition that could justify the discomfort, you need to undergo tests for gout. This disease occurs when too much uric acid crystals are deposited around the joints, causing pain. Most patients initially experience pain in the big toe, although any other joint can be affected. Doctors usually use arthrocentesis or order a blood or urine test to perform tests.
Steps
Part 1 of 3: Prepare for your Doctor's Appointment
Step 1. Review your entire medical history
Certain diseases, such as diabetes, high blood pressure (if you don't have treatment), and other heart or kidney problems may make you more susceptible to gout.
- Likewise, some forms of cancer can also lead to gout, such as leukemia and lymphoma.
- Also take note of any serious illness, infection, or trauma you have suffered from, especially if in recent times.
Step 2. Find out if any other family members have had gout
In this case, you may be genetically predisposed to the disease; ask your parents if they know of any relatives who have had this problem.
Step 3. Make a list of the medicines you are taking
As is always the case during a medical examination, the doctor will want to know if you are following any drug therapy. Sometimes, the active ingredients cause side effects that you are not aware of, they can lead to some other ailment and be the cause of the problem that causes you to go to the doctor. Also, your doctor wants to know if any medications he will prescribe may interact with the ones you are already taking.
For example, thiazide or loop diuretics in combination with low-dose aspirin may increase the risk of gout
Step 4. Make a note of the symptoms
Observe when you feel pain, for example twice a day or only in the evening; note which part of the body aches, such as the knees or toes; Also look out for other symptoms you may experience, such as redness, swelling, decreased range of motion, or pain in some joints.
Step 5. Keep a food diary
It consists of a list of the foods you eat each day and the approximate portion sizes. For example, you can note that you ate 170g of meat for dinner, along with 80g of broccoli and 120g of mashed potatoes topped with half a tablespoon of melted butter.
The food diary can be important in diagnosing gout, because those who eat large amounts of meat, consume a lot of alcoholic beverages or foods rich in fructose are at greater risk of suffering from it
Step 6. Write down any concerns
For example, you may want to know if the pain is due to another type of arthritis; in the same way, you may wish to understand if the cause of your problem is attributable to the drugs you are taking. Write down all these questions, so you don't forget them during your visit to the doctor.
Part 2 of 3: Taking Gout Tests
Step 1. Be prepared to answer questions
One of the main techniques used by the doctor to diagnose the disease is precisely that of asking questions; use the notes you have made about the symptoms to provide the answers.
For example, the diagnosis of gout is more plausible if the pain started in the big toe and later developed in the other joints as well; for this reason, your doctor may ask you which areas are the most painful
Step 2. Prepare for the arthrocentesis test
This is the most common test for diagnosing this disease; the doctor uses a needle to extract synovial fluid from the joint, which is analyzed under a microscope to check for the presence of sodium urate crystals, which indicate the presence of gout.
Step 3. Be ready for a blood draw
Blood testing is another popular method for evaluating the disease. The blood is analyzed to define the concentration of uric acid; however, this test has some problems, as it may show a high level of uric acid, without the patient suffering from gout. Conversely, you may instead have the disease, despite the fact that the blood concentration of uric acid is within normal limits.
- In fact, doctors don't always prescribe blood tests until a month has passed after the suspected gout attack, as the uric acid concentration may not be high enough until then.
- For the same reason, a urine test is performed in some cases. Basically, the patient is asked to urinate in a small, clean container; the urine will then be sent to a laboratory to define uric acid levels.
Step 4. Find out why your doctor might order you an ultrasound
This test allows to detect the level of uric acid crystals in the joints and skin; usually, it is done when you experience intermittent, sharp pain and if one or more joints are affected by gout. If you are afraid of needles, you can ask your doctor for this type of exam instead of arthrocentesis.
Step 5. Ask your doctor to examine your physical condition for any other illnesses
If you think the joint pain is not due to gout, you can visit yourself to diagnose other possible causes. your doctor may take an x-ray to see if your joints are inflamed, in which case they would indicate another problem.
Part 3 of 3: Treatment
Step 1. Try pain relievers
Your doctor may recommend these medications, from over-the-counter versions you may already have at home, to stronger ones on prescription.
- In severe cases, he might prescribe pegloticase (Krystexxa).
- The non-steroidal anti-inflammatory drugs (NSAIDs) that are usually used to treat gout are celecoxib (by prescription) or ibuprofen (free for sale).
- The doctor may also prescribe the anti-inflammatory colchicine, although its side effects are so severe for some people that it is not always the best option.
Step 2. Learn about corticosteroids
They can provide relief from discomfort, especially if you can't take NSAIDs; these drugs can also be injected directly into the suffering area or taken orally, when the pain is more widespread.
Step 3. Be prepared for the possibility of taking preventive medications
If you have repeated gout attacks, your doctor may prescribe medicines to prevent them. They are drugs that fall into two categories: those that block the production of uric acid and those that remove it from the body in greater quantities than what the body is able to dispose of on its own. Those most often prescribed are allopurinol, febuxostat and probenecid.
Step 4. Cut down on alcohol and fruit juice consumption
Both alcohol and soft drinks rich in fructose can aggravate gout; try to replace these drinks with water as often as possible.
Step 5. Limit the meat and some fish
Both can increase uric acid concentrations in the body; this organic molecule is in fact produced when the body processes purines, chemicals that are present in large quantities in some types of meat and fish.
If you can, especially avoid beef, pork, and lamb. You should also give up some fish, such as anchovies, herring, shrimp and other types of seafood; offal, such as the liver, heart and kidneys, are also high in purines
Step 6. Maintain a regular physical activity routine
Exercise helps you lose weight and keep you healthy in general; Since obesity is a risk factor for gout, reducing weight can also decrease the chances of suffering from it.
Choose low-impact activities, as gout may cause you pain when moving. Try swimming or walking; Aim to exercise regularly, at least half an hour a day five times a week
Step 7. Undergo surgery as a last resort
The tophi are large deposits of uric acid crystals that form in various parts of the body, creating swellings under the epidermis; they usually develop around the joints and bones. If you don't treat gout, you may develop tophi large enough to require surgery to remove them, as they can limit the range of motion of the joints. Kidney stones represent another complication, because they can block the ureter, causing hydronephrosis.
