Gout: An Overview of the Etiology, Stages, Diagnosis, Treatment and Future Outcomes
Pulling, Jaime L.
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Gout is a systematic disease that is caused by the buildup of uric crystals in joint spaces of the body due to the enhanced purine metabolism. The supersaturation uric acid in these joint spaces leads to inflammation, swelling and extreme pain. Gout affects approximately one million Americans, but is not limited to only the United States. Gout is a progressive disease that is caused by years of hyperuricemia (high serum urate levels). It typically begins with an acute, painful attack in the great toe triggered by infection, surgery, excessive alcohol or a simple stub of the toe. The first attack is usually short, followed by a period of time without any symptoms. At this point, attacks can become more frequent and painful. This chronic stage of gout leads to tophaceous deposits on the skin. Many patients have asymptomatic hyperuricemia, which is a predisposition for gout. Gout is a treatable disease without permanent damage to the joints or kidneys if diagnosis is made in a timely fashion. When diagnosing and treating gout, rheumatologists and primary care physicians need to be especially careful due to the high number of gout imitators, such as pseudogout and rheumatoid arthritis, because these diseases present similar clinical characteristics. Treatment for gout varies on the patient's progression of the disease. Asymptomatic gout and acute gout are treated for symptoms only, whereas, chronic gout is has a preventative treatment. These treatments usually exhibit some toxic effect, thus new research is always being conducted to improve medications. Unfortunately, gout is an incurable disease due to its many etiologies, but luckily for gout suffers technology and research allows patients to live more pain free lives.