Gout Arthritis

Uric acid is a normal ingredient in the body and the end result of purine metabolism, the degradation of purine nucleotide which is an important ingredient in the body as a component of nucleic acids and produce energy in the cell nucleus. Under normal circumstances a proper balance between formation and degradation of purine nucleotides as well as the ability of the kidneys to excrete uric acid. If there is excess formation (overproduction) or decreased excretion (underexcretion) or two there will be an increase in the concentration of blood uric acid, called hyperuricemia. Circumstances would risk the onset of hyperuricemia with gout arthritis, gout nephropathy, or kidney stones.

Hyperuricemia is a medical term that means conditions in the blood uric acid levels exceed the "normal" is more than 7.0 mg / dl. Hyperuricemia can occur due to increased production or decreased removal of uric acid, or a combination of both. Persistence conditions predisposing to hyperuricemia (supporting factors) a person has arthritis due to gout (gouty arthritis), kidney stones caused by uric acid or renal impairment.

Gout arthritis is a disease caused by deposition of monosodium urate crystals that occur due to super saturation of the extra cellular fluid and result in one or more clinical manifestations.

Symptom
Symptoms of gout will be marked with the initial attack that attacks the joints will usually last for several days and then disappear until the next attack. Symptoms of gout should really watch out to avoid gout attacks are more severe. Other symptoms of gout are usually characterized by the following symptoms:

• Muscle pain, knee joints, hips, back, hips, shoulders and shoulder joints affected by gout visible swelling, redness, heat and tremendous pain during the night and morning.
•   Body aches and often feel exhausted
• Taste Tingling and pains are very severe
       
•  Frequent urination especially at night or early morning when I wake up
     
•   If symptoms of uric acid was also attacked in the kidney area will lead to bladder stones, so people are difficult to urinate

Symptoms of gout is a pain in the joints due to the crystallization of uric acid formed in the peripheral joints. This is because the joints are colder than in the center of the body. In cold temperatures veins tend to freeze. Other symptoms of uric acid that can result from crystallization in the joints is a very severe tingling.

DIAGNOSIS
Pseudogout, septic arthritis, rheumatoid arthritis

Examination support
• ESR, CRP
• Analysis of joint fluid
• Uric acid blood and urine 24 hours
• U, creatinine, CCT
• Radiology joints

THERAPY
1. Counseling
2. Acute phase of treatment:
    a. Colchicine. Dose of 0.5 mg given every hour until there is improvement there is inflammation or signs of toxic or dose not exceed 8 mg/24jam
    b. Anti-inflammatory non-steroidal
    c. Low-dose glucocorticoids if any contraindications of colchicine and non-steroidal anti-inflammatory drugs.

3. Treatment of hyperuricemia:
    a. Low-purine diet
    b. Xanthine oxidase inhibitors (for the overproduction of type), such as allopurinol

COMPLICATIONS
• Tofus
• joint deformity
• gout nephropathy, renal failure, urinary tract stones