Ok, Male 52yo history of hypertension and degenerative ...

Dear catnharnh,

Gout is a painful inflammation usually affecting the joints in the the great big toe(s) and feet as a result of overproduction of uric acid. Sometimes the cause is due from the inability of the kidney's to get rid of excess uric acids. Unfortunately, there are some medications that have also been responsible for interfering with the clearance of excess uric acid excretion.

Gout has been found to be more common in males, postmenopausal women, and people with high blood pressure. Heavy alcohol use, diabetes, obesity, sickle cell anemia, and kidney disease also increase the risk and can ultimately lead to chronic renal failure. Pain and stiffness of the affected joint can develop along with fever AND an inflammation of other joints in the body including foot, shoulder, hands, wrists, knees, and others. (Although the toe(s) are most common.)

Your doctor can perform tests to confirm such diagnosis for gouty arthritis, treatment can be implemented. Such tests include:

(1) Fluid analysis of the synovial joint that can determine if you have uric acid crystal as well as synovial biopsy.

(2) An elevation in uric acid level (urine AND/ OR blood tests.)

(3) X-rays of the joint to determine damage that has resulted in gouty arthritis.

With a confirmed diagnosis by your doctor, treatment is available with medications to reduce uric acid levels; such include: allopurinal which blocks the enzyme that produces the uric acid. Also Chronic gouty arthritis is treated with drugs like probenecid or sulfinpyrazone, which also reduce uric acid levels. These are medications that need to be prescribed by your physician. In addition you will want to drink plenty of water or other fluids to reduce the risk of kidney complications.

Your best bet is to check with your doctor ASAP to perform the necessary tests for proper diagnosis and treatment. Remember, as I mentioned above, if gout is not treated, serious kidney problems can occur.

In the meantime, avoiding foods that are high in purine may help relieve "flare ups" of gout. (I will provide a dietary link at the bottom to help you follow a low purine diet. Ibuprofen may also provide relief of swelling and pain as well as elevating the affected foot, AVOIDING alcohol, and try using warm compresses to the joint. If cool compresses give you more relieve....go ahead and use cold instead.

Below is a link to a site that shows the foods you should avoid as they contain high-purine diets that are not good for people who suffer from gout. Please let me know if you need any other information:

http://www.webmd.com/hw/health_guide_atoz/ty2036.asp?navbar=hw69013

Regardless of the information provided here, you should really see your doctor for some medical intervention ASAP.

Edited by AnnlynnRN on 13 July 2006 at 6:30pm

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As I mentioned,this has not responded as have other gout attacks.This is the first time my knee has been involved.The onset was overnight, with no mechanism of injury.While my gout problems have all subsided in less than three (unpleasant) weeks this has endured far longer-first date I can identify is May 3rd....Also beyond swelling there is some gross deformation of the joint itself-most obviously a widening and flattening of the patella and a pronounced widening of the medial side of the entire knee.Distally the profiles appear ok bilaterally...This is in the least swollen,"good" condition...The knee itself is mildly unstable,not merely painful as in gout...in short I don't think we've got it yet...I guess I should say this seems more like an organic deal than gout-as if the knee physically degraded almost overnight and now has no hope of recovery by drugs alone.In the best of times the instability in a standig position feels almost as if both mininscuses (sp?) had disappeared overnight...try again?