Question:My brothers and one uncle have gout of the big toe. It seems I might have gout of the fingers developing. Have you ever heard of gout affecting the hand?
Answer:Gout affects the joints and is a disease caused by a problem with uric acid metabolism. Sometimes this condition is referred to as metabolic arthritis.
In this condition, there is an elevated amount of uric acid in the blood. Uric acid crystals form and get deposited on joint surfaces, tendons and surrounding soft tissues.
An inflammatory reaction of these tissues occurs. The deposits often increase in size. They can form tracks through the skin and out to the surface. A chalky white material may ooze from the skin. Sometimes the affected individual can squeeze a liquid or pasty substance out of the area.
The feet (especially the big toe) are affected most often. But the fingers and hands can also develop gout. The location of gout in the peripheral joints may be because the temperature of the hands and feet is lower than the rest of the body. And the urate crystals tend to form at lower temperatures.
Symptoms of gout in the hands and wrist are more likely in people who have chronic gout. But the incidence of symptoms in the hands and fingers is less likely now with improved medical care. The tips of the fingers are involved most often. Experts think this is related to arthritic changes seen in the distal interphalangeal (DIP) joints.
Gout can rupture tendons so early treatment is advised. Medical management with drug therapy is the first step. Nonsteroidal antiinflammatory drugs (NSAIDs) are the first line of medications. Rest, elevation, and ice are helpful during acute attacks.Brian T. Fitzgerald, MD, et al. Gout Affecting the Hand and Wrist. In Journal of the American Academy of Orthopaedic Surgeons. October 2007. Vol. 15. No. 10. Pp. 625-635.
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