Symptoms
The symptoms of an acute attack of gout can vary from patient to patient both in intensity and duration. However, pain in the affected joints and in the surrounding tissue are among the typical symptoms of an acute attack of gout. In addition, all classic signs of inflammation can be detected in the joints.
A joint affected by a gout attack increases in size to swelling (tumor), shows a characteristic redness (rubor) and is overheated compared to the adjacent, unaffected tissue (calor). Furthermore, the affected joints are severely restricted in their natural function (Functio laese) and emit strong pain stimuli, the intensity of which increases with touch (Dolor). In addition, the activation of the immune system triggered by the attack of gout results in an increase in the number of leukocytes (white blood cells) in the serum.
Infestation of the joints
In principle, the acute attack of gout can manifest itself in almost any joint of the body. It should also be noted that not all joints are affected during a gout attack. The typical symptoms are usually limited to a few joints.
Nevertheless, it can be observed that different joint regions are affected more frequently, whereas gout symptoms hardly ever occur in other joints. The ankle joints and the joints of the toes are most frequently affected by attacks of gout. There is a special name for the occurrence of a gout attack on the big toe joint, the so-called podagra or foot gout. Furthermore, many affected persons show gout symptoms in the knee joints. In the area of the upper extremities, the finger joints and wrists (Chiragra) are most frequently affected.
Gout attack diagnosis
The diagnostic detection of a gout attack is divided into different sections.As a rule, the extensive doctor-patient consultation, in which the patient explains the existing problems, provides an initial indication of the presence of gout. This is usually followed by a physical examination, during which the attending physician examines the affected joints and checks for swelling, redness and possible overheating. In addition, blood tests play a decisive role in the diagnosis of gout attacks.
One of the most significant indicators for the presence of a gout attack is the so-called uric acid level. However, caution is advised with this laboratory value. If the uric acid concentration increases in combination with the typical symptoms, a gout attack can be assumed quite reliably, but a uric acid value in the normal range does not rule out the presence of this disease.
The reason for this fact is that the detectable concentration of uric acid in the blood depends on what the patient has eaten and drunk. For this reason a normal-value uric acid concentration does not necessarily have to be an exclusion of a gout attack. Besides the uric acid level, the number of white blood cells and the blood sedimentation rate (BSG) in the blood are also determined.
In a gout attack, both values are classically elevated. It is questionable whether an x-ray can be taken to diagnose an acute attack of gout. Visible changes in the bones can usually only be observed in X-rays in chronic forms of gout. Alternatively, a so-called urography can be performed, which, in contrast to the X-ray image, also allows the detection of individual urinary stones. If anything is unclear, a joint puncture with subsequent detection of urate crystals in the synovial fluid (synovial fluid) may also help to confirm the diagnosis.