72 year old male from Texas with history of Gout for 2 years in his right knee presents with complaint of pain and swelling. Patient states prior to onset of gout he was fine without any discomfort. Past medical history is unremarkable.

Patient takes no medications and has no allergies. He has tried conventional treatments with some relief. He is currently active and working everyday in construction business.

Discussion:

This is a common cause of arthritis (joint inflammation). It typically appears as an acute attack overnight. Within 12-24 hours pain and swelling becomes severe. Sometimes the knee feels hot and looks red.

Usually affects only one joint, mostly the big toe and ankles. If not treated, inflammation usually subsides in a week or two, and sometimes does not come back for may be a year or longer. Eventually these attacks may produce severe joint damage and disability .Gout affects mostly men.

Uric acid is a chemical which is a natural part of the normal breaking down and building up of food and body tissues. When the uric acid is at a high level it forms microscopic crystals in the joint. These crystals set up the inflammation which is called acute gouty arthritis or acute gout. Higher than normal levels of uric acid can be part of the inherited make-up of some families. Alcohol intake, high intake of certain foods (Purines) and some blood pressure medicines may precipitate gouty attacks. The best way to treat gout is a diet and avoidance of the following foods:

• Excessive amounts of red meat. Liver, kidneys, tripe, sweetbreads and tongue.

• Shellfish, fish roe and scallops.

• Peas. Lentils and beans.

• Alcohol intake should be reduced.