Reasons: ① Excessive uric acid production ② Reduced uric acid excretion by the kidneys

Arthritis is the most common spontaneous symptom.

The most commonly affected part - the first metatarsophalangeal joint (big toe)

Symptoms include sudden onset of single, occasionally bilateral or multiple joint redness, swelling, heat, pain, dysfunction, and joint effusion, accompanied by fever and leukocytosis.

It often occurs suddenly at midnight or early in the morning. Severe pain in the joints may appear like tearing, cutting or biting pain. Redness, swelling, heat, pain, and dysfunction of the affected joints occur within a few hours.

Common triggers: alcohol consumption, fatigue, joint injuries, surgery, infection, cold, intake of high-protein and high-purine foods, etc.

Tophi - is a characteristic lesion of gout, caused by urate deposition. The typical site is the auricle.

Clinical manifestations include persistent joint swelling and pain, tenderness, deformity, and joint dysfunction.

White bean dregs-like crystals, sesame and egg yolk white ridges

Gouty nephropathy: early nocturia, late stage hypertension, edema, azotemia, high creatinine (renal insufficiency)

Uric acid nephrolithiasis: sediment-like uric acid urinary tract stones. Severe cases include renal colic and hematuria.

Uric acid drugs: inhibit the reabsorption of urate by the proximal renal tubules - suitable for patients with good renal function - benzbromarone, probenecid

Drugs that inhibit uric acid production: reduce uric acid production - allopurinol

Alkaline drugs: alkalize urine – sodium bicarbonate

Non-steroidal anti-inflammatory drugs - first-line drugs for acute gouty arthritis

Colchicine—traditional, bone marrow transplant, renal failure.

Glucocorticoids – rebound

Treatment goal: Keep blood uric acid <360 μmol/L to reduce or eliminate monosodium urate crystals deposited in the body

Indications for the use of urate-lowering drugs: acute gout recurrence, multi-joint involvement, occurrence of tophi, chronic tophi arthritis, imaging changes in affected joints, and concurrent uric acid nephrolithiasis.

After the acute attack is relieved for 2 weeks, start with a small dose, gradually increase the dose, adjust to the minimum effective dose according to the target level, and maintain it for a long time.

Bed rest: prop up the quilt on the bed and raise the affected limb to avoid pressure on the affected part and weight bearing on the affected joint.

Local care: If the elbow or wrist is affected, use a splint to immobilize it. Apply ice or 25% magnesium sulfate wet compress to the affected joints. Take good skin care

Diet care: avoid high purine levels, abstain from alcohol, and eat alkaline foods (milk, eggs, potatoes, citrus)

Observation of the disease: ① Pain: whether there is waking up due to severe pain in the middle of the night ② Affected joints: redness, swelling, heat, pain and dysfunction ③ whether there are predisposing factors ④ signs of tophi ⑤ changes in body temperature ⑥ changes in uric acid

psychological care

Medication care

Try to use large muscle groups, be able to use your shoulders without using your hands, and be able to use your arms without using your fingers

Avoid heavy physical labor that lasts for long periods of time

Make frequent changes to yourself to keep affected joints comfortable

Warmth and swelling of the joint, avoid moving it

If the pain lasts for more than 1-2 hours after exercise, temporarily stop the activity.