Gout patients often say that their gout will [shift]:
Two years ago, I had a pain in my left big toe, but recently I became a right big toe?
Before, only one foot hurt, but now both feet hurt and the ground can’t get down!
Before, my toes hurt, but now my ankles, elbows and knees hurt…
It seems that this gout will really shift. Is that really the case? Let’s talk about gout [transfer].
The [shift] in the doctor’s eyes is a very important matter.
In the eyes of many patients, gout changes from one place to two or even more places, or from one place to another, which should be gout [metastasis]. Some friends even call this phenomenon [metastatic gout].
However, the term “metastatic gout” has not appeared in authoritative medical books such as < < Internal Medicine > > < < Kelly Rheumatology > > which doctors often read.
Therefore, although [metastatic gout] can vividly describe the change process of gout, it is unscientific. If you tell your doctor [you have metastatic gout] during the visit, the doctor may not be able to understand it.
However, doctors usually use [metastasis] to describe neoplastic diseases, which means that the primary tumor appears in other parts of the body through lymph, blood circulation, etc., such as gastric cancer transferred to the lungs. Usually, [tumor metastasis] means the aggravation of the disease.
Gout [metastasis] is mostly a manifestation of poor uric acid control.
For gout patients, if the gout site changes or increases, it is mostly a manifestation of poor gout control.
Many patients know that gout attacks are caused by the deposition of urate crystals in the joint cavity. [Uric acid crystal deposition] may sound abstract. You should have had the experience of sprinkling salt into a glass of water, and the salt can dissolve at the beginning. As more and more salt is added, the salt cannot dissolve, thus forming salt crystals in the water.
And gout attack is also the truth. When the level of uric acid is low, uric acid can dissolve in the blood. When the level of uric acid is too high, uric acid cannot dissolve in the blood, it will precipitate and deposit into the joint cavity. You think, sprinkle a handful of [salt] into the joint, of course it will hurt!
Although gout has frequent joints, such as the first metatarsophalangeal joint (big toe), if uric acid is at a high level for a long time, urate crystals may appear in all joints (toes, ankles, knees, elbows, etc.) of the whole body, resulting in gout [transfer].
In fact, this is not a transfer, just because uric acid is not well controlled, the affected joints change or increase. However, the harm of long-term poor uric acid control is far more than pain, and tophus, kidney damage, etc. may also occur.
Gout may also occur during uric acid reduction.
Some patients may also suffer from gout [metastasis] during taking uric acid-lowering drugs such as allopurinol, febustat and benzbromarone.
This is because when taking acid-lowering drugs, urate crystals originally deposited in the joint cavity will dissolve (partially), thus causing pain.
Therefore, in the process of uric acid reduction treatment, doctors often let patients take some drugs to prevent gout attacks, such as colchicine, so that patients can smoothly pass the initial uric acid reduction treatment period.
Avoid gout [metastasis], please do this
Knowing the cause of [gout metastasis], I believe it is not difficult for everyone to think of its treatment and prevention methods:
1. Standardize the use of acid-lowering drugs
The root cause of gout is that the level of blood uric acid is too high. Only by reducing the level of blood uric acid to 360 mol/L (without tophus) or 300 mol/L (with tophus) can urate crystals be prevented from depositing in more joints and gout [metastasis].
At the same time, standardized medication to reduce uric acid can also promote the dissolution of crystals already formed in the joint cavity.
2. Prophylactic use of painkillers
In order to avoid acute attack or gout [metastasis] in the early stage of uric acid reduction treatment, patients should also use colchicine and other drugs to prevent gout attack under the guidance of doctors.
I believe it is not difficult to avoid gout [transfer] if both of these two points are done well.