WHAT IS THE TREATMENT FOR GOUT OR PSEUDOGOUT?
* Be aware that the recommended treatments of illnesses are always being improved.
This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.
1. The treatment is the same for gout as pseudo gout; however, the prevention of gout and pseudo gout are different. The medication to treat both gout and pseudo gout are Prednisone, Colchicine, and NSAIDS. There is no clear cut benefit of one medications over the other.
2. Prednisone * (if there is NO indication of infection)
3. NSAIDS *
A. Naproxen
B. Ibuprofen
C. Diclofenac potassium
D. Meloxicam
E. Indomethacin
F. Celecoxib
4. Colchicine —OR——NSAIDS (Indomethacin, Naproxen)[not usually both]; Colchicine is best when the medication are started early in gout flare up. Colchicine can be combined with NSAIDS-but they both do the same thing (reduce inflammation), so this is NOT usually recommended. # *
5. Triamcinolone acetonide intra-articular injection *
6. Medications that lower uric acid in the blood should be continued if a person is already taking, but not started during a gout flare up. These medications are the following: allopurinol, febuxostat, probenecid, lesinurad, benzbromarone, or pegloticase. #
CAUTION:
1. It is important to try to make certain that the diagnosis is really Gout and not an infection,
especially when Prednisone is given. A joint infection will require antibiotics, gout does not.
Prednisone or prednisolone will make an infection worse.
2. NSAIDS (Naproxen, Indomethacin) can be used in combination with Colchicine;
however, since they are both reduce pain and inflammation it is best to use one or the other.
3. All medication, including medication used for gout, have a risk of side effects.
4. Mild side effects are nausea, vomiting, diarrhea, itching, and light skin rash.
5. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction
(leading to the inability to breathe and subsequent death if not treated rapidly),
and Clostridioides difficile infection (C. Diff.) of the colon.
6. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that
are not easily seen.
Consult “Epocrates.com”
for each Specific Medication’s possible “Adverse Reactions.”
Side effects are also referred to as “Adverse Reactions.” Epocrates.com will
tell you both “common reactions” and “serious reactions.” You will have to
create an account, but it is simple, fast, and free.
WHAT ARE THE SYMPTOMS OF GOUT OR PSEUDO GOUT?
Usually if someone has has gout the effected joint feels hot, its swollen, and it very painful (especially if touched). The most common joint effected is the big toe. However, gout can also be in the feet, ankles, knees, and elbows.
WHAT IS THE CAUSE OF GOUT OR PSEUDO GOUT?
Gout: The primary cause of gout is that the body either produces an excessive amount of uric acid—or the body does not excrete a sufficient amount of uric acid in the urine. Either way the end results is that there is an increased amount of uric acid in blood. This excess or uric acid in the blood then causes uric acid to move outside the blood into a joint space and form uric acid crystals. These uric acid crystals in the joint cause the joint to become inflamed, swollen, and painful.
Pseudo gout: The cause is similar to gout—except the crystals are from calcium pyrophosphate deposition—not from uric acid crystals.
HOW IS GOUT OR PSEUDO GOUT DIAGNOSED?
Gout can be diagnosed by a careful history. The diagnosis can be proven by removing fluid from a joint with a needle and syringe and finding crystals in the fluid with a microscope. Sometimes an X-ray or an ultrasound of a part of the body can show a uric acid crystal; however, this can not be done for all part of the body.
Pseudo gout can also be diagnosed by a careful history. The diagnosis can also be proven by the examination of the fluid from a joint.
Some blood test might be needed to determine if the joint inflammation is due to rheumatoid arthritis vs gout or pseudo gout.