Q. Clinical Features of gout disease?

You may be enjoying good heath but may suddenly get a severe attack. You wake up in the middle of the night, and your big toe feels as if it is on fire. It is hot, swollen and so tender that even the weight of a blanket on it seems intolerable. These problems could indicate an acute attack of gout characterized by sudden, severe attacks of pain, redness and tenderness in joints.

The big toe gets affected mostly but in chronic conditions, it could be the elbow or the helix (outer fleshy ridge of the ear) can also be the site. The uric acid crystals (called tophi) deposit as urate 'in the joint causing swelling and tenderness of the joint with severe pain. Figure illustrates the uric acid crystals in the big toe. Presence of uric acid crystals in the joint fluid, therefore, is an important diagnostic test for the disease. The doctor will take a sample of the joint fluid and look for the presence of uric acid crystals. Gout is also easily identifiable through a physical examination the skill is tense, red and shiny and may be associated with fever, anorexia (lack of appetite) and malaise (un well feeling)

The main complication of chronic gout is, however, chronic renal failure. That is a big problem! So, what can we do to prevent and treat this metabolic disorder?