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Arthritis  (Expert Forum)
 | 
gout and pseudogout?
Answered by
Dr Vinod - Exercise & Fitness, Orthopedics
General Physician Gurgaon - India

gout and pseudogout?

by johannTrainer, Aug 07, 2009 01:11PM
hi doctor.  I've been getting a lot of pain in my feet and my girlfriend thinks it is gout.  what should I do to treat it?  also, I know that there are dietary changes to be made, but I eat healthy foods, yogurt, salad, chicken, no red meat.  is there something I should be taking to help?  she also suggested it may be pseudogout?  can you tell me more about it, how it relates to arthritis and what the difference is between gout and pseudogout?

by Dr Vinod, Aug 08, 2009 08:54PM
To: johannTrainer
Greetings from the arthritis forum! We would be glad to give you full details about Gout!

Gout is a disease hallmarked by elevated levels of uric acid in your blood. In this condition, crystals of monosodium urate (MSU) or uric acid are deposited on the articular cartilage of joints, tendons, and surrounding tissues.

Gout is characterized by excruciating, sudden, unexpected, burning pain, as well as swelling, redness, warmth, and stiffness in the affected joint. This occurs most commonly in men's toes but can appear in other parts of the body and affect women as well.

The urate crystal has a needle-like morphology and strong negative birefringence under polarised light. This test may be difficult to perform. The most informative clinical signs are the presence of classic podagra (sudden, unexplained swelling and pain of the big toe joint on just one foot). High uric acid levels, ( does not necessarily mean a person will develop gout.)

Pseudogout the Chondrocalcinosis is a very similar disease, caused by deposition of calcium pyrophosphate rather than uric acid.

The first line of treatment should be pain relief. Once the diagnosis has been confirmed, the drug options are of nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and oral glucocorticoids, or intra-articular glucocorticoids administered via a joint injection.
Patients are often started on a drug such as allopurinol, which inhibits the conversion of purine into uric acid.

Foods to Avoid:
Beer, anchovies, organ meat (brains, kidney, liver, sweetbreads), game meats, gravies, yeast, meat extracts, sardines, herring, mackerel, scallops.

No Restriction:
Breads and cereals (low-fiber, white flour, or refined grain types), nuts, peanut butter. Vegetables not high in purines, soups - cream style or vegetable without meat extract, coffee, tea, fruit juices, soft drinks, gelatin, sugar, low fat cheeses.

Gout Diet - Foods That May Help:
Some people have found cherry juice or strawberries helpful. Some chemicals contained in dark berries may help reduce the inflammation and lower the uric acid.
Oily fish like salmon, or fatty acids in flax seed or olive oil or nuts may reduce inflammation too.
It has been suggested that using tofu (from soybeans) instead of meat could also be helpful.

Take care and come back to us with further queries.



Member Comments (2)

by Lobo44, Oct 06, 2009 12:43PM
To: Dr.Vinod
In reference to Gout, how are the purines or uric acid removed from the body, I am aware of urination, but my question is, does the body secrete it from sweating also?? Thanks.
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