Chronic gouty arthritis

Description:

Gout – the disease with disturbance of purine exchange and accumulation of uric acid in an organism proceeding with repeated attacks of acute arthritis.  Gout  was known in the ancient time and described by Hippocrates.

The crystals causing gouty arthritis are urates, salts of uric acid which collect in bones, kidneys. An important symptom, except arthritis, are tofusa – whitish small knots on an ear lobe, brushes, feet.

Men have gouty arthritis almost only. At an early stage it is monoarthritis, then polyarthritis. Sometimes arthritis begins with a knee or ankle joint, but arthritis of the first metatarsophalangeal joint in an onset of the illness meets more often.

Symptoms of Chronic gouty arthritis:

Chronic gouty arthritis arises most often only after the period of intermittent gout and, as a rule, in that joint where earlier several acute joint attacks were observed (seldom — chronic arthritis develops in the joint which before is not affected or after the first attack of acute arthritis).

Its localization is various: most often inflammatory changes appear in joints of feet, then in joints of hands, talocrural, elbow and knee; more rare — in shoulder, hip, grudino-cellular joints.

The first symptoms of chronic gouty arthritis are feelings of the constraint of a joint appearing after a dormant period and also a crunch at the movements. Further moderate pains at loadings join, rigidity increases and accepts constant character, there is a moderated, and then and expressed deformation of a joint caused at first by exudative, and then and proliferative changes of joint and periartikulyarny fabrics. There is a secondary osteoarthrosis. The osteolysis caused by intra bone adjournment of urates is capable to lead to destruction of the epiphyseal ends of the jointed bones that can be shown clinically, for example, in shortening of fingers. Occasionally there are incomplete dislocations and dislocations. At formation of a false or bone ankylosis mobility of a joint is lost completely.

Feature of exacerbations of chronic gouty polyarthritis is less expressed pain syndrome which considerably concedes in intensity at "the joint attacks" of intermittent gout, but arises more often and proceeds during longer time — up to several months. Though in the period of a chronic gout there can be typical acute attacks of arthritis in those joints which were never surprised earlier and do not find signs of chronic inflammatory process.

Damages of kidneys — the most adverse symptom of this disease; it is noted within 15 — 75% of cases (on average at a chronic gout in 50 — 60% of cases).

Reasons of Chronic gouty arthritis:

Classical" gout develops at the people having genetic predisposition to this disease. And the potential patient can even not suspect about the heredity.

Let's tell if his parents or relatives lead a healthy lifestyle, do not abuse alcohol and eat properly, then the disease at them can not be shown and all life will exist only in the latent, hidden look. And our potential patient having predisposition to this disease will provoke at himself a disease only if conducts not absolutely healthy (from the point of view of tendency to gout) a way of life.

So, typical подагрик — it is frequent (but not always) the stout man abusing either alcohol, or so-called "purine food stuffs": meat, meat soups, smoked products, fish and salty food, offal (liver, kidneys), beans, haricot, chocolate, grape wine.

At abuse of the listed products there is an increased education in blood of uric acid which, in turn, forms badly soluble salt of urate of sodium. When concentration of uric acid in blood reaches limit, its salts in the form of microcrystals are besieged in a joint cavity, forming peculiar "depot" there.

Existence of microcrystals of urate of sodium in a cavity of a joint is for it a serious irritant. But nevertheless crystals can be long time in a joint asymptomatically — until any provocation (a physical overwork, a stress, long starvation or, on the contrary, search of "purine products" and alcohol) does not provoke the acute gouty attack.

Treatment of Chronic gouty arthritis:

Treatment of gouty arthritis without diet is senseless. A source of uric acid are nitrogenous substances (purines). Therefore an exacerbation of gouty arthritis it is possible to warn strict restriction of meat, fish. At arthritis dairy products, fruit, vegetables, cucumber juice are useful.

Now for therapy of exacerbations of chronic gouty arthritis non-steroidal anti-inflammatory drugs are used (sodium diclofenac, indometacin in doses to 200 mg a day, Rapten slow motion).  Data on high performance at gouty arthritis  of Nimesulide are obtained (100 mg twice a day).