Common Cause of Painful Big Toe
Gout is a systemic disease that results from the deposition of uric acid crystals in tissues. Increased serum uric acid above a specific threshold results in the formation of uric acid crystals. Despite the fact that hyperuricemia is the main pathogenic defect in gout, many people with hyperuricemia do not develop gout or even form urate crystals. In fact, only 5% of people with hyperuriceamia above 9 mg/dL develop gout. Accordingly, it is thought that other factors such as genetic predisposition share in the incidence of #gout
Uric Acid crystals can be deposited in all tissues mainly in and around the joints forming tophi. Gout is mainly diagnosed by identification of the pathognomonic urate crystals by joint fluid aspiration or in tophi aspirate. Early presentation of gout is an acute joint inflammation that is quickly relieved by NSAIDs or colchicine. Renal stones and tophi are late presentations. Lowering serum uric acid levels below deposition threshold either by dietary modification and using serum uric acid lowering drugs is the main goal in management of gout. This can result in dissolution of #UricAcid crystals preventing further attacks. #jointpain
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