Gouty arthritis

Diagnosis

Gout is typically identified by a doctor based on your symptoms and the way the affected joint looks. Tests that help identify gout may consist of:

• Joint fluid test. Your doctor may use a needle to remove fluid from the affected joint. The fluid is then examined under a microscope to determine if urate crystals are present. This test can help confirm a diagnosis of gout and guide appropriate treatment.
• Blood test. A blood test is a common method used by doctors to determine the concentration of uric acid in the blood. However, the results of these tests are not always reliable indicators of gout. Some individuals may have high levels of uric acid but never experience gout symptoms, while others may have gout symptoms but normal uric acid levels in their blood.
• X-ray imaging. Joint X-rays can be useful in excluding various sources of inflammation in the joints.
• Ultrasound. This examination makes use of sound waves to find urate crystals in tophi or joints.
• Dual-energy Computerized Tomography (DECT). X-ray pictures from various angles are combined to see urate crystals in joints.

Treatment

There are two basic types of gout drugs that each target a different issue. The first kind aids in reducing the pain and swelling brought on by gout attacks. The second type reduces the level of uric acid in your blood to prevent gout complications.

The frequency and seriousness of your symptoms, as well as additional health problems you might have, will determine which kind of medication, which is best for you.

Medications to treat gout attacks

Medications used to treat gout flare-ups and prevent new attacks include:

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs). In addition to over-the-counter NSAIDs like ibuprofen and naproxen sodium, stronger prescription NSAIDs like indomethacin or celecoxib are also available. NSAIDs come with hazards of ulcers, bleeding, and stomach pain.
• Colchicine. Colchicine, an anti-inflammatory medication that significantly lessens gout pain, may be suggested by your doctor. The negative effects of the medication, such as diarrhea, nausea, and vomiting, may outweigh its benefits.
• Corticosteroids. Prednisone and other corticosteroid drugs may reduce the pain and inflammation associated with gout. You can take corticosteroids orally or have them injected directly into your joint. Corticosteroids’ adverse effects can include raised blood pressure, elevated blood sugar levels, and mood disturbances.

Drugs used to avert complications associated with gout.

If you experience frequent gout attacks or severe symptoms, your doctor may prescribe medication to reduce your risk of gout-related complications. The aim of this medication may be to lower the level of uric acid in your body. This may be recommended if you have tophi (lumps of uric acid deposits under the skin), chronic kidney disease, a history of kidney stones, or evidence of gout damage on joint X-rays. The goal of treatment is to reduce the frequency and severity of gout attacks and prevent long-term joint damage.

• Medications that block uric acid production. Allopurinol and febuxostat are medications that assist in reducing the production of uric acid in your body. Allopurinol has a number of adverse effects, including fever, rash, hepatitis, and kidney issues. Rash, nausea, and a decline in liver function are all side effects of fenoxostat. Febuxostat may also raise the chance of mortality from heart-related causes.
• Medications that improve uric acid removal. Probenecid, among other medications, helps your kidneys do a better job of eliminating uric acid from your body. A rash, stomach ache, and kidney stones are examples of side effects.