Читать книгу Arthritis For Dummies - Barry Fox - Страница 87

Sometimes the symptoms of gout “speak” loudly, making diagnosis fairly easy. Other times, they can be vague, making diagnosis a real head-scratcher.

The best, most reliable test for gout is joint aspiration (arthrocentesis) — that is, using a needle to drain fluid from the affected joint, and when examining it under the microscope, finding it contains uric acid crystals. Your doctor will also look for tophi (lumps of uric acid underneath the skin that appear chalk-like), and tender and swollen inflamed joints. If tophi are present, your gout is considered severe and chronic. Your doctor may also X-ray the afflicted joint.

Gout is curable with medications, so long as you take them daily and your doctor adjusts the dosage of your medication to ensure that your uric acid levels stay below a certain threshold.

For treatment of a gout flare, high doses of NSAIDs (see Chapter 8) are used to ease pain and inflammation.Steroids may also be injected directly into the joint to reduce inflammation, and your doctor may insert a needle into the joint and draw out the excess joint fluid to relieve the pain and pressure.

If you have more than two gout flares per year, you have tophi, and/or an X-ray shows that your have permanent joint damage due to gout, your doctor will likely recommend chronic urate lowering therapy (for life), using a medicine such as allopurinol or febuxostat that lowers uric acid to levels where crystals cannot form.