Symptoms of gout

A gout attack manifests itself in almost all cases at so-called predilection sites, i.e. almost always at the same joints. Mostly the metatarsophalangeal joint of the big toe is affected. One speaks then of the clinical picture “Podagra”. Other joints can also be affected. Affected joints usually fulfill all signs of an acute inflammation: they are reddened, very warm, very painful, swollen and no longer move well.

Cause

The clinical picture of gout develops because the uric acid level in the blood of those affected is permanently elevated. The uric acid settles in the joints in the form of uric acid crystals and causes an inflammation. The reasons for this can be both increased production and reduced excretion of uric acid.

This can occur if there is a disorder in the uric acid metabolism itself – for example, if there is a reduced secretion of the kidney (little excretion of uric acid) or an initially increased endogenous production of uric acid (more rarely, usually in the context of genetic diseases) – or in connection with other diseases. Thus, some tumors of proven dimensions lead to increased uric acid production and kidney damage leads to a reduced excretion of all breakdown products of the body. Uric acid crystals can be deposited in the following places: Very painful are deposits in joints and tendon sheaths.

In the beginning, the metatarsophalangeal joint of the big toe or the metatarsophalangeal joint of the thumb is usually affected. The fact that gout is practically non-existent in times of need, but becomes very common in times of abundance, shows how strongly nutritionally dependent the development of a gout attack is. Hyperuricemia (medical term for excessive uric acid levels) and gout often occur in the context of a so-called metabolic syndrome, which is characterized by a coincidence of:.

An increase in the concentration of uric acid in the blood occurs when uric acid is excreted in increased or decreased amounts. An excessive intake of purines with food promotes this development. Uric acid is excreted via the kidneys and the intestines, whereby excretion via the kidneys is most frequently disturbed.

Joints
Carpal tunnel
Bones
Urinary tubules (kidney) and
In connective tissue
Overweight (apple type = fat accumulation in the abdomen)
Lipometabolic disorders
High blood pressure
Disorders of sugar metabolism and diabetes type 2