There can be many ways in which gout or pseudogout presents itself clinically. While experiencing an acute gout attack, a majority of people often present involvement of a single joint. However, the doctor will examine all the joints of the person before prescribing gout medication. Moreover, it is important to examine different joints to find out if the person is suffering from monoarticular or polyarticular gout. The joints experiencing gout will show signs of inflammation like warmth, tenderness, swelling, and erythema.
The erythema atop the gouty joints often mirrors cellulitis. Moreover, the joint capsule can be swollen which can lead to loss of motion in the joint. The person can feel feverish in the case of an acute gout attack. This is particularly true in the case of polyarticular gout.
Migratory polyarthritis is rarely presented. In the case of polyarticular gout, small joints of the toes and fingers, as well as the knees will be involved. Moreover, there can be the presence of an inflammatory synovial effusion. Rarely, acute cases of gout may also present as carpel tunnel syndrome. Besides, people with established gout can also suffer from chronic arthritis and the affected joints will have swelling and tenderness that can be associated with or without redness, and joint damage.
Even though gout can cause joint inflammation, it can also lead to inflammation in other structures like tendons and bursae that are synovial based. When urate crystals get collected in the soft tissues, it is called tophi. Tophi usually develops after a decade worth of untreated gouty arthritis. However, in the case of women, particularly those women who take diuretics, it can develop earlier.
Although the helix of the ears is their usual location, tophi can also be found in different locations like the toes, fingers, and the prepatellar bursa. The presence of a seemingly rheumatoid nodule in a person with a negative rheumatoid factor should prompt the consideration of gout in the diagnosis.
Discussed above are two ways in which gout and pseudogout present themselves clinically. Medical science has also documented the involvement of eyes as a very rare but a definite aspect of gout. Also, tophi have been described to be found in the eyelids too. Moreover, blurring of vision from corneal haze or the sensation of a foreign body from the breakdown of epithelium can also occur. Your rheumatologist will consider these things before diagnosing and prescribing gout medicine for you.