Gout In The Knee: Telltale Signs
Knee gouts distinct symptoms include:
- Inflammation in and around the knee joint
- A warm or hot feeling in the knee
- Skin reddening or shininess
- Skin flaking and itching when inflammation subsides
- Extreme pain and sensitivity
Because gout pain in your knee can be so severe, you may not be able to tolerate the slightest touch or put any weight on your knee.
Gout attacks known as flares come suddenly and can even wake you in the middle of the night. These can last anywhere from a few days to over a week.
Will Gout Go Away
In many cases, gout knee pain will settle down on it’s own after a couple of weeks. However, this is not always the case, particularly with recurrent attacks of gout.
Gout symptoms often get progressively worse with repeated episodes. The pain and swelling may be more severe and last longer with each episode of gout knee.
If you have developed trophi, deposits of uric acid crystals, in one or more of your joints, you will notice hard, nodular growths at one or more of your joints. In severe cases, these can cause lasting damage to the joint. But in most cases, with appropriate treatment, the trophi will disappear.
Reducing Uric Acid Levels
Tip: If you really enjoy seafood, there are a few options that are low in purine, such as salmon, mahi mahi, snapper, and tilapia. These fish shouldnt raise your uric acid levels.XResearch source
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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
Which Joints Are Involved In Gouty Arthritis And Why Is It Most Common In The Foot
As with all other known types of arthritis, Gout has particular joints it tends to attack, and the foot is its most common location. Gout especially favors the bunion joint, known as the first metatarsophalangeal joint , but the ankle, midfoot and knee are also common locations, as is the bursa that overlies the elbow.
The bunion joint is the first joint involved in 75% of patients and is ultimately involved in over 90% of those with this condition. . It is thought that this joint is especially involved in gout because it is the joint that receives the highest pounds per square inch of pressure when walking or running.
Late in gout, if untreated, multiple joints can be involved, including the fingers and wrists. The shoulder joint is very rarely involved by gout and the same is true of the hip.
Figure 5: Location of Gout Attacks
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Purines And Uric Acid
The crystallized uric acid that causes gout pain is created by the breakdown of a substance called purines. Purines are part of every cell that make up all plant and animal food sources. Purines are also produced by the human body itself.
Some foods, namely proteins like meats and beans, are higher in purine content that others. One way that high levels of uric acid accumulate in the blood is by eating these types of foods. Another way is by consuming drinks and foods that are made with a generous amount of high fructose corn syrup.
However, the true problem is that the kidneys are temporarily not able to balance the pH of the body chemistry as they normally do. Kidney function can become impaired for a number of reasons in addition to consuming certain types of foods toxic environmental chemicals in the air and water, stress hormones, dehydration, skin contact with toxic substances, physical over-exertion, and others.
When the kidneys are overloaded, the uric acid may not be properly processed and excreted. Normally, uric acid is produced and used by the body as a protective antioxidant, but when over-abundant, its corrosive nature can become problem.
The alternative that nature has provided is to allow the excess uric acid to crystallize in a joint far from the vital organs to protect them this is the fundamental point to understand when the question, what is gout? comes up.
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.
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Reduced Range Of Motion
Whether youre having an attack or have endured permanent damage, your joints will not fully function. Due to inflammation or damage, your range of motion may be hindered. This means that both the distance and direction that a joint can move, will essentially decrease. This is especially common within ones knee joints, however, some simple exercises can help prevent stiffness. If youre experiencing inflamed joints, its best to seek advice from your physician. Its important to remain active, reducing the possibility of overly stiff joints.
Easing Back Into Walking And Exercise After A Gout Flare
After a gout flare subsides, Dr. Iversen suggests aquatic exercises may be a good way to start re-engaging in exercise because the buoyancy of the water will reduce the impact on the joints.
Low-impact aerobic exercises can be helpful, too, such as on an elliptical machine. She says its important to keep your joints flexible by incorporating stretching and range-of-motion exercises once the gout flare subsides to promote good joint movement.
Be careful not to overdo it once you ease into post-flare exercise, she cautions. Patients should not be experiencing pain when walking once the flare has subsided. If you do experience pain with walking after a flare, go back to using a walking support and reduce your planned exercise until the pain subsides.
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How Common Is Gout In The Knee
As a general rule of thumb, if left untreated, gout tends to work its way up the body, Dr. Keenan explains.
For example, he cites research that shows 50 percent of patients experience their first gout attack in the big toe. If gout worsens, 35 percent of secondary flares occur in the knee, 40 percent in the midfoot and ankle, 30 percent in elbows and wrists, and 15 percent in fingers.
Its not uncommon for a person to experience their first gout flare in their knee and, after an X-ray or ultrasound, show signs of gout in the foot, he adds.
Gout can afflict both knees, but typically is felt more strongly in one knee where arthritis from general wear is worse.
How Would I Know For Definite That Its Gout
Diagnosing gout starts with an examination and asking about your medical history. We might then arrange a blood test to determine your urate levels . Imaging like ultrasound and CT scans can be helpful too. Finally, we can also arrange to take a sample of fluid from your joint so the crystals can be identified under a microscope.
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When To Contact A Doctor
People who are experiencing symptoms they think might be due to gout should seek guidance from a doctor.
Gout tends to progress and worsen over time. However, early treatment can often help control gout and reduce the risk of severe complications, such as joint damage.
People with gout can also develop infections, which they need to treat as soon as possible. Those who have diabetes are more likely to develop infections with gout.
A person should seek emergency medical care if signs of infection are co-occurring with symptoms of gout.
How Is Gout Treated
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
- Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
- Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help.
- Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
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Additional Tips For Treating Gout Naturally
Studies show that many of the dietary items we consume lead to gout as well as other health problems. Changing your diet and lifestyle may be the easy solution to beating gout. One of the first things to do is eliminate certain foods and beverages from your diet to beat gout.
1. Eliminate or reduce sugar intake
As many studies are now illustrating, gout is common in people with excessive sugar intake, especially high fructose corn syrup Its wise to read the labels of all your food and drinks. If you find HFCS then eliminate that from your diet. In addition, look for sugar added under the guise of other common names for sugar look for cose at the end of words and these are probably types of sugar you dont want to be consuming.
2. Eliminate grains
Grains in the body are converted to sugars so again you want to limit or avoid grains altogether. They are also very inflammatory to your body.
3. Limit alcohol consumption
Again, alcohol becomes sugar once ingested so eliminate this completely unless you have a healthy body already. Any substance that will be converted to one or another type of sugar by the body should be avoided at all costs. In order to get your uric acid levels down you must consistently avoid sugar in your diet.
4. Eliminate soda and diet soda
5. Consume cherries and strawberries daily
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How Does A Doctor Diagnose Pseudogout
Pseudogout is suggested when abnormal calcifications are seen in the cartilage of joints on X-rays. These calcifications are referred to as chondrocalcinosis and very suggestive of a diagnosis of pseudogout when there is also inflammation of the involved joint.
The diagnosis of pseudogout is ultimately made when fluid from a joint is extracted and is examined under a special microscope called a polarizing microscope. With this microscope, the calcium pyrophosphate crystals are clearly identified by their characteristic shape and color .
The arthritis of pseudogout is common in older adults, particularly in the context of dehydration such as occurs with hospitalization or surgery.
The treatment of pseudogout is directed toward stopping the inflammation in the joints. Local ice applications and resting can help. Nonsteroidal anti-inflammatory drugs such as ibuprofen and others are often first drugs of choice.
Removing fluid containing the crystals from the joint can reduce pain and help the inflammation to diminish more quickly. Cortisone injected into an inflamed joint will also help decrease the inflammation. Colchicine is a medication used to decrease inflammation in patients with gout and may also be helpful in pseudogout. Corticosteroids taken as a pill can help if the patient can’t tolerate colchicine or NSAIDs.
Long-term prevention of recurrent pseudogout is often best achieved with small daily doses of colchicine and optimal hydration.
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Common Gout Knee Symptoms
In most cases, the symptoms of gout in knee develop rapidly over a few hours.
Common gout knee symptoms include:
- Pain & Swelling: The knee joint quickly becomes hot, swollen and red and usually becomes extremely sore
- Night-Time Onset: Gout knee symptoms usually start at night due to lower body temperatures
- Skin Changes: the skin around the knee joint often looks shiny and there may be small, firm lumps under the skin, known as trophi
- Fever: Sometimes, gout results in a raised body temperature
- Reduced Function: Gout knee often makes weight-bearing activities such as walking and going up and down stairs incredibly painful
How Do You Treat Gout In The Knee
There are a number of treatment options for gout knee pain:
- Medication: There are various medications that can help reduce gout knee pain. Colchicine helps to reduce urate levels, steroids can help to reduce the pain and swelling associated with gout knee as can over the counter medications such as ibuprofen
- Supplements: There are a huge number of supplements on the market that claim to reduce gout knee pain, often derived from cherries and celery, but you should always check with your doctor before taking any gout supplements. They can be used alongside other treatments but should never replace conventional medicine
- Ice: Regularly applying ice to your knee can help to reduce any swelling and gout knee pain. Ice should be wrapped in a cloth or placed in an ice bag before being applied to the knee, and can be used for up to 15 minutes at a time, regularly during the day
- Rest: Give your knee a break and try and rest when you can to take the pressure off your knee. Keep your leg raised, ideally so your knee is higher than your heart to help reduce any knee swelling
- Fluids: Drink plenty of fluids, preferably water -avoid alcohol and fizzy drinks
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What Are The Causes And Triggers Of Gout In The Knee
The buildup of uric acid in the body is known as hyperuricemia. Your body produces uric acid when it breaks down purines. These are compounds found in all your cells. You can also find purines in several types of food, especially red meat and some seafood, as well as alcohol and some sugar-sweetened drinks.
Usually, uric acid passes through your kidneys, which help to eliminate extra uric acid in your urine. But sometimes, theres too much uric acid for your kidneys to handle. In other cases, the kidneys cant process typical amounts of uric acid due to an underlying condition.
As a result, more uric acid circulates throughout your body, ending up in your knee as uric acid crystals.
4 percent of adults in the United States. It tends to be more common in men because women usually have lower levels of uric acid. But after menopause, women start to have higher uric acid levels. As a result, women tend to develop gout at an older age than men do.
Experts arent sure why some people produce more uric acid or have trouble processing it. But theres evidence that the condition is often genetic.
Other things that may increase your risk of developing gout include:
- consuming a lot of high-purine foods
- consuming foods and drinks, especially alcohol, that increase uric acid production
- being overweight