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 النقرس Gout

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مُساهمةموضوع: النقرس Gout   الجمعة 17 أكتوبر 2008, 20:58

Definition


Acute gouty arthritis is a sudden attack of pain in the joints, especially in the feet and legs, that occur when uric acid builds up in the joints.






Causes



Gout is caused by an overproduction of uric acid or a reduced ability
of the kidney to get rid of uric acid. The exact cause is unknown. It
is more common in males, postmenopausal women, and people who drink
alcohol.


The condition may also develop in people with:



• Diabetes


• Kidney disease


• Obesity


• Sickle cell anemia



The condition may occur after taking medicines that interfere with uric acid excretion.






Gout has 4 stages:



• Asymptomatic


• Acute


• Intercritical


• Chronic



Symptoms



Symptoms develop suddenly and usually involve only one or a few joints.
The big toe, knee, or ankle joints are most often affected.



The pain frequently starts during the night and is often described as
throbbing, crushing, or excruciating. The joint appears infected with
signs of warmth, redness, and tenderness.



The attacks of painful joints may go away in several days, but may
return from time to time. Additional attacks usually last long. Some
people may progress to chronic gouty arthritis, while others may have
no further attacks.




Specific symptoms include:



• Fever (sometimes)


• Joint pain


• Joint swelling of the affected joints


• Joint stiffness


• Joint redness


• Skin lump which may drain chalky material



Exams and Tests



Tests that may be done include:


• Blood differential


• Joint x-rays (may be normal)


• Synovial biopsy


• Synovial fluid analysis (shows uric acid crystals)


• Uric acid- blood


• Uric acid - urine






Treatment



A prescription medicine called colchicine helps reduce pain, swelling,
and inflammation associated with acute gout attacks. The medication
decreases the inflammation caused by uric acid crystals within the
joint. It does not decrease the uric acid levels in the bloodstream.



The pain often goes away within 12 hours of starting treatment, and is
completely relieved in 48 hours. Daily use of colchicine or allopurinol
helps prevent future attacks.



Your doctor may also recommend that you take non-steroidal
anti-inflammatory drugs (NSAIDs) as soon as symptoms start to relieve
pain and inflammation. Strong painkillers such as codeine may
occasionally be prescribed.



Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.



Drinking more fluids helps prevents the formation of kidney stones.



Sometimes, a diet low in purines is prescribed. Organ meats, beer,
wine, and certain types of fish contain high levels of purines.



Prognosis



Proper treatment of acute attacks allows people to live a normal life.
However, the acute form of the disease may progress to chronic gout.



Possible Complications



• Side effects of medications


• Chronic gouty arthritis


• Kidney stones


• Kidney dysfunction




Prevention



The disorder itself may not be preventable, but you may avoid things
that trigger your symptoms. Limit alcohol consumption and follow a
low-purine diet

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مُساهمةموضوع: رد: النقرس Gout   الجمعة 27 أغسطس 2010, 01:55

thank u for these helpful informations
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