HALLUX RIGIDUS (ARTHRITIS OF BIG TOE JOINT)

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Chances are you have heard of Gout before. Gout is a disorder that occurs from excessive build-up of uric acid in the tissues or joint, resulting in intense pain, redness and swelling. The condition occurs abruptly with no immediate cause and can be very debilitating to a person.

Uric acid is a normal chemical that presents in the body through the breakdown of certain foods. It usually resides in the blood and is eliminated in urine. Patients with gout do not eliminate uric acid properly, thus retaining the additional amount. It tends to crystallize into a solid structure and cause symptoms.

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The risk factors for individuals to have a gout attack is often inherited. However, there are other factors that put patients at high risk. These include high blood pressure, diabetes, obesity, chemotherapy, and stress. Also, certain medications such as diuretics, niacin and aspirin can make an individual susceptible to the condition.

HOW GOUT IS FORMED

Gout attacks occur due to the body retaining uric acid, which crystalizes into a solid structure and deposits within a joint. The most common area for a person to experience gout is the big toe joint. This is due to sensitivity to temperature changes within the body.

The big toe joint is the furthest joint away from the heart where blood is pumped and as a result, much cooler in temperature. Uric acid is more likely to turn into crystals in cooler temperatures, thus making the big toe joint the most common location in the entire body to experience an attack.

There are two main reasons Gout can occur:

  1. Too much uric acid introduced into the body via food
  2. Kidneys having difficulty eliminating normal amounts of uric acid Diet is the biggest contributing factor of gout; It is due to continuous accumulation of food that is high in purines, which are the structures that break down into uric acid. Foods high in purines include red meats, shellfish, red wine, beer, and organ foods such as livers and kidneys.

Gout most commonly affects people between the ages 40-60 and men more than women. This is due to a women’s ability to produce estrogen, which commonly fights and prevents uric acid crystallization of Gout to occur.

SYMPTOMS

  • Sudden redness, swelling and intense pain to big toe joint or ankle
  • Pain with light touch, such as bedsheets rubbing on toe
  • Warmth to joint or area

TREATMENT

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Gout is often diagnosed by clinical signs and a person’s medical history. X-rays are often taken to see if inflammation has affected the integrity of the big toe joint and caused arthritic changes. Laboratory tests may be indicated to determine the severity level of the condition as well as any chronic changes for medical management.

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Conservative treatments are usually all that is required to treat the condition. The symptoms are treated with a form of prescription medication to treat the pain, swelling and inflammation seen. This is often through a powerful anti-inflammatory or steroid medication. Once the acute symptoms are resolved, your doctor can discuss with you measures to control future outbreaks. This includes dietary restrictions of foods high in purines, drinking more water, and long-term medication.

If you are exhibiting early indication of pain or discomfort, visit your podiatrist at Premier Foot & Ankle for care!

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