Gout

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Gout is an inflammatory rheumatic disease resulting from the deposition of sodium monoate crystals (a form of accumulation of uric acid). It is more prevalent in men and very rare in women before menopause.

 

The drop results from the deposition of sodium monoate crystals (a form of accumulation of uric acid) in the joints, but also in other locations. This phenomenon occurs when the levels of uric acid in the blood are chronically high.

Other risk factors to consider are: genetic, dietary factors (ingestion of alcohol or purine-rich foods such as shellfish, meat and viscera), co-morbidities (including metabolic syndrome, obesity, hypertension, diabetes, psoriasis...) and the use of some drugs.

 

The drop initially evolves with an acute and intermittent phase, i.e., with crises of joint inflammation (arthritis) interspersed with asymptomatic periods. The crisis periods may be triggered by external factors, such as local trauma, drugs and intake of purine-rich foods and alcoholic beverages.

Usually in the early stages of the disease only one joint is affected, the most typical location being in the lower limbs, particularly the 1st toe (podagra), ankles and knees. The joints of the upper limbs (hands, wrists and elbows) may be affected more rarely and later. During the crisis, patients may also report general (systemic) inflammatory symptoms such as fever. Seizures can be self-limited (regression in 1 to 2 weeks), but the start of appropriate therapy aims to shorten their duration.

With progression to chronicity, seizures tend to reach more joints and be more frequent and prolonged, with shorter asymptomatic periods (until symptom-free periods no longer exist). 

 

In order to prevent gout crises and their potential consequences, it is essential to educate and raise awareness among patients about changing lifestyles and adherence to hypouricemiant treatments. Regular exercise, a regular diet and compliance with chronic medication are the means to avoid the long-term consequences of gout.

Objectives of a rehabilitation program:

  • Improving mobility and joint movement

  • Relief from pain and inflammation

  • General physical reconditioning

  • Teaching and counselling of support products (orthotics, splints, etc.)

  • Return to work activities , daily life and sports activities  

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