What is gout in knee?
Gout in knee is an inflammatory condition that causes swelling and pain in the knee joints. In the US, approximately 1-2 people in every 100 suffer from gout. Men are more likely to be affected by this condition than women with a peak-incidence age of 75. There are recurrent episodes of this condition, which can be excruciatingly painful. Although gout can affect the knees, toes, ankles, hands, and wrists, it often affects the base of the big toe.
If a person complains of a hot, red, painful, and swollen knee, gout in knee should be considered.
Causes of Gout in Knee
When there are increased levels of uric acid in the blood, gout develops. Uric acid is waste produced by the body when it breaks down certain substances, such as purine from the foods we consume. It is usually excreted in the urine, but when problems with uric acid metabolism occur, such as when the body produces excessive amounts of urate or when the kidneys are not quickly passing urate, the levels of uric acid increase and form in the soft tissues of the body. It particularly affects around a joint, such as the knee.
This uric acid buildup triggers an inflammatory response, which causes hot, swollen, and painful joints. Uric acid crystals usually form when temperatures are cool. It is the reason why gout commonly affects the feet and hands. The levels of uric acid in the blood are usually increased for many years before gout knee symptoms develop.
You are more likely to develop the condition if you have the following risk factors:
- Genetics - Having a family history of gout increases your risk of developing the condition.
- Age and Gender - Men are more likely to produce uric acid than women. However, women's uric acid levels may also increase after menopause. It commonly affects people who are older than 40 years old and peaks at age 75.
- Obesity - Having a body mass index (BMI) of more than 35 increases the risk of gout three times.
- Diet - Drinking excessive amounts of alcohol or fructose-based drinks as well as eating too much seafood can increase the risk of gout in almost 12 percent of the cases.
- Medical Conditions - Kidney problems can impair the body's ability to eliminate waste products and cause the levels of uric acid in the blood to increase. Other conditions that are associated with gout are diabetes, thyroid gland problems, and high blood pressure.
- Drug Treatments - There are medications that can raise the uric acid levels in the body. They include medications that contain salicylate and diuretics or water pills.
- Trauma - Gout in knee may also develop after surgery or an injury.
Acute episodes of gout usually come suddenly over a few hours. Its symptoms often occur at night because of lower body temperatures. People with gout usually complain of their joints feeling hot, swollen, and extremely sore.
In the affected area, small but firm lumps under the skin are observed. The skin in this area is often shiny. In some cases, fever due to gout may be experienced. Gout in knee usually makes weight-bearing exercises and activities, such as walking extremely painful. Recurrent episodes of gout are often common. Usually, people with gout tend to have a recurrence within 6 months to 2 years. Around 60 percent of people with gout will have a recurrent episode within 12 months.
Doctors can diagnose gout knee by evaluating a patient's signs and symptoms, including his or her medical history, certain risk factors, and previous gout attacks.
The doctor's diagnosis can be confirmed by doing certain blood tests or by performing joint aspiration, which is a procedure to remove joint fluid using a needle and syringe. The collected fluid is then sent to the laboratory and examined under the microscope to look for uric acid crystals. Tests that measure kidney function may also be done to confirm a gout knee diagnosis.
When gout in knee is left untreated, the episodes often settle down within two weeks or longer. To help speed up the healing process, the following treatment options can help during gout knee attacks:
- Nonsteroidal Anti-Inflammatory Drugs or NSAIDs: Examples of these drugs are ibuprofen and naproxen. These medications can work quite well if they are immediately taken when symptoms start to develop. However, always inform your doctor about taking any type of medications for your gout knee.
- Steroids: Steroids can be taken to help reduce pain and inflammation. They can be orally taken or via injections.
- Rest: Avoid engaging in strenuous events, limit weight-bearing activities, and try elevating your legs to help reduce the inflammation and swelling of your joints.
- Ice: An ice pack can be applied to painful joints. Cold can help relieve inflammation and pain.
- Colchicine: It is a medication that can help reduce swelling and uric acid buildup in the affected joints.
In some cases, gout affects or spreads to other joints. Another complication of gout is when uric acid crystals form in the kidneys, leading to scarring, inflammation, and renal calculi (kidney stones).
Over the past two decades, the incidence of gout has doubled. Dietary and lifestyle changes are often the reasons for the significant increase of gout-related diseases. Prevent gout by practicing healthy eating habits and a healthy lifestyle.
- Avoid Excessive Alcohol Consumption: Urate levels can be significantly increased when there is an excessive intake of beer, fortified wines, and stout.
- Lose Extra Weight: People who are overweight and obese are more likely to develop gout.
- Avoid Sugary Drinks: Avoid drinks that are sweetened using high-fructose corn syrup. Examples are fruit drinks and diet sodas. The sweeteners in these drinks can stimulate the body to produce more uric acid.
- Stay Away from Purine-Rich Food: Examples are offal, oily fish, pulses (peas, lentils, and beans), and vegetables, such as spinach and asparagus.
- Drink Plenty of Water: Drinking plenty of water can help hydrate your body and help flush uric acid out of the body through urination. To prevent gout, aim for 2-3 liters of water a day.