Saturday, May 4, 2013

Differential Diagnosis of Gout - What Causes The Joint Pain?


The differential diagnosis of patients presenting with joint pain is extensive, ranging from mild sprain, joint dislocation, trauma, malignancy, infection, and some life-threatening autoimmune diseases.

Joint pains that caused by physical activities are very obvious and easy to be diagnosed. Examples of this kind of injury are sprained ankle, joint separation, ligament sprain, torn cartilage and torn cartilage. Usually, this kind of pain is immediate and the patient can vividly remember the physical activity that causes the pain at the joint. These kinds of traumatic condition can happen to people of all ages.

Other causes of joint paint that usually affect people of older age are osteoarthritis and rheumatoid arthritis. Osteoarthritis is the result of mechanical degradation of the joints due the years or wear and tear. It usually happens to those who were physically active during their younger years, such as sportsman or those who work in hard labour jobs.

One the other hand, rheumatoid arthritis is form of autoimmune disease where the abnormal immune system attacks the tissues around the joints and causes inflammation and pain. The actual cause of rheumatoid arthritis is still unknown, some say it is because of viral or bacterial infections, some say it is because of genetically inherited abnormalities. Extensive researches are still taking place around the world to find out the answer to this mysterious illness that affects a huge number of elderly population.

Although these 2 types of arthritis have very different causes, but they share certain similar symptoms that make them easy to be ruled out in the differential diagnosis of gout. Both osteoarthritis and rheumatoid arthritis usually develop the pain over a long period of time and they usually affect joints of both sides of the body such as in the feet, hands. These kinds of arthritis usually attack multiple joints at the same time and the pain develops gradually.

Another more common cause of joint pain in the modern day is gouty arthritis which is more commonly known as gout. Gout attack is a type of inflammation that is caused by the formation of urate crystals inside a particular joint due to long term exposure to hyperuricemia. Many times, gout is mistaken as one of the above mention arthritis conditions, especially when the patient get the gout attack for the very first time.

Differential diagnosis of gout is very straight forward and easy, here are some of the unique properties of gout that differentiate it from other causes of joint inflammation.

  • Suddenly occurrence of intense pain

  • The attack starts in the middle of the night when the victim is sleeping

  • It usually attack one side of the joints

  • 90% of the gout attacks happen at big toe

  • If blood test is conducted, it usually shows a high blood serum uric acid level that is beyond healthy range

Although Gout is easy to be diagnosed, but it is not easy to get rid this awful devil. Those gout drugs and pain killers can only temporarily control the gouty inflammation, none of them can remove the root cause of gout, which is the urate crystal.

It is commonly known among the gout patients that gout pain is the worst and most unbearable pain in their life. Instead of wasting your money on those expensive tests involved in the differential diagnosis of gout, you should spend some time to understand the actual cause of gout and remove the root once and for all.

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