If you are crazy, basically it is best to take a CT scan.
Gout is a crystal-related arthropathy caused by the deposition of monosodium urate. It is directly related to hyperuricemia. When uric acid in our body increases beyond saturation, it is precipitated and deposited in joints and other tissue parts. Triggering an inflammatory reaction will lead to the occurrence of gout, but it should be noted that only about 5 to 12 people with hyperuricemia will develop gout. Ideally, "cure" can be achieved as long as the uric acid crystals deposited in joints and other tissue parts are completely decomposed and excreted, but in real life this goal is difficult to achieve. What we hope to achieve is to prevent acute attacks of gout and the formation of tophi. , help dissolve tophi and achieve long-term relief of symptoms.
Formal treatment of gout patients is very important. Once diagnosed, strict improvement of living habits and drug uric acid-lowering treatment are required. As uric acid decreases (when it is lower than 360umol/L or people with tophi are lower than 300umol/L) urate crystals will gradually decompose and be excreted, helping to relieve symptoms and control the condition. If tophi is completely dissolved and urate crystals are completely excreted, the ideal "cure" will be achieved. Therefore, we must treat it regularly and strive to achieve long-term and stable control to avoid attacks and disease progression.
Gout patients should pay attention to the following in daily life: ① Avoid eating or eat as little high-purine foods as possible: avoid eating animal offal, shelled seafood and broth, and eat less animal meat (beef) , pork, mutton, fish, etc.), eat less soy products; ② Quit smoking and limit drinking: you must quit smoking, and do not drink white wine, beer, rice wine, but you can drink red wine appropriately; ③ Do not drink fructose-rich beverages: such as cola, fruit juice etc.; ④ Avoid strenuous exercise and sudden cold; ⑤ Increase the intake of fresh vegetables: more than 500g per day is appropriate; ⑥ Drink more water: 2000ml per day is appropriate, including tea and coffee; ⑦ Insist on appropriate exercise and pay attention to weight control; ⑧ Regular work, rest and diet.
Drug treatment for gout patients is very important, and mainly includes: ① Acute stage: mainly symptomatic and analgesic, uric acid-lowering treatment is contraindicated, non-steroidal anti-inflammatory drugs, colchicine or glucocorticoids can be used; ② Remission period: Active uric acid-lowering treatment should be carried out to ensure long-term remission of the condition. The main options are allopurinol or febuxostat, which inhibits the production of uric acid, and benzbromarone, which promotes uric acid excretion. For general gout patients, we recommend that the goal of lowering uric acid is to control uric acid below 360umol/L. For patients with tophi, they should try to control uric acid below 300umol/L, which is more conducive to the decomposition and elimination of tophi. It should be noted that uric acid cannot be reduced too low. Long-term levels below 180umol/L will increase the incidence of Alzheimer's disease and multiple sclerosis.