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TORONTO CHIROPODIST, D.Ch., B.Sc., PODIATRIC MEDICINE

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Gout is a form of arthritis hence it causes pain and discomfort in the joints. A typical gout attack is characterized by the sudden onset of severe pain, swelling, warmth, and redness of a joint. The clinical presentation of acute gouty arthritis is not subtle with very few mimics other than a bacterial infection. Gout may be linked to excessive consumption of alcohol, red meat as well as shellfish/crabs. 

The joint most commonly involved in gout is the first metatarsophalangeal joint (the big toe). The big toe is a common spot as uric acid crystallises (crystallizes) more easily in a cold environment. The toes are one of the coldest parts of the body, along with other extremities such as the fingers. Cold weather too is a gout trigger. Hence gout sufferers, or those prone to it, must dress warmly in cold weather - especially the feet, and wear gloves, because gout can attack the fingers - and be careful about dress if they work in a cold environment. Any joint may be involved in a gout attack (and it may be more than one) with the most frequent sites being in the feet, ankles, knees, and elbows.

An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack (without treatment) takes approximately 7-14 days.

Some patients only experience acute gout attacks which may be limited to 1-2 times per year (or even 1-2 times in lifetime). However, for some patients, gout can be a chronic, relapsing problem with multiple severe attacks that occur at short intervals and without complete resolution of inflammation between attacks. This form of gout, called chronic gout, can cause significant joint destruction and deformity and may be confused with other forms of chronic inflammatory arthritis such as rheumatoid arthritis. Frequently, uric acid tophi (hard, uric acid deposits under the skin) are present and contribute to bone and cartilage destruction. Tophi are diagnostic for chronic tophaceous gout. Tophi can be found around joints, in the olecranon bursa, or at the pinna of the ear. With treatment, tophi can be dissolved and will completely disappear over time. 

Treatment of gout may involve patient compliance - patients are advised to limit their alcohol, red meat and seafood consumption. Patients are also advised to drink lots of water and stay properly hydrated. Patients may also be put on NSAIDs or receive corticosteroid injections. Referral back to a family doctor for preventative medications may also be beneficial. Thus, it is important to be aware of the risks associated with gout and how it can affect the population.

Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

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Academy Clinics has a special interest in high quality custom orthotics.

 

416-465-8737

Toronto, ON Chiropodist
Academy Foot and Orthotic

752 BROADVIEW AVENUE
Toronto, ON M4K 2P1 

Across from the Broadview Subway
Professional  Family  Foot  Care

PROFESSIONAL
FOOT CLINIC

CHIROPODIST / FOOT SPECIALIST,  B.Sc. PODIATRIC MEDICINE / ACADEMY FOOT & ORTHOTIC CLINICS, 752 Broadview Ave , Toronto ON, M4K 2P1 416-465-8737