Colchicine For Gout: Gout: Not just for Men
Gout, a form of arthritis that seems to be more common in men than in women, actually does not discriminate according to gender. Women can suffer from this particular painful condition, too, especially after the menopause. Some studies even suggest that there is a definite increase in women with gout, particularly among the aging female population. The exact reason for the rise of gout among women remains uncertain. An Increase in age, obesity, alcohol consumption, hypertension, and diuretic use have traditionally been associated with the risk of developing gout among women and men.
- Medications that may be a contributing cause of Charcot joints include;
- Injectable and systemic use of steroids Phenylbutazone Indomethacin Vincristine
Treatment of Charcot Joints
The hallmark of treatment of Charcot joints is early diagnosis and prevention. The symptoms and findings of Charcot joints vary so that each case requires careful evaluation. Remedy of Charcot joints of the feet may include rest, sending your line and non-weight bearing to allow adequate time for fracture healing. Total contact casting or the use of a Charcot Restraint Orthotic Walker (CROW) are popular in stages one and two. The goal is to limit weight bearing to enable progression to stage three. This progression can take from several weeks up to 6 months. Electrical stimulation, or even bone arousal, is a trendy adjunct in order to non-weight bearing or throwing.
X-Rays are the Single Most Useful Tool in Diagnosing Charcot Joints
Bone scans are helpful in the early phases of Charcot joints and are sensitive indicators of hyperemia (increased blood flow to the area of the fracture). Surface skin temperature is one of the most reliable indicator of the activity of the fractures. Most doctors do not keep the necessary equipment in order to measure skin temperature but merely measure with direct touch to sense the presence or lack of warmth.
Charcot Joints Occur When the Ability to Sense Deep Pain is Lost or Diminished
As a result of the inability to sense pain, small fractures begin to develop in areas of tension such as the arch of the foot. The normal response to a fracture is swelling and increased blood flow (reflex vasodilatation) to the affected area of bone. The increase in blood flow tends to 'wash away' calcium from the fracture site, resulting in weakening of the bone as well as further fractures. If the normal protective mechanism, pain, remains absent, a cycle of increasing fracture activity begins with progressive collapse of the supporting bone.
Gout, is not just a disease for men. It is also in increasing numbers of women suffer from gout. Colcrys 0.6 mg tablets may be prescribed for prevention and treatment of gout. Take a look at more gout information at http://www.colchicine.ca/
- Type 3A - Ankle joint - 9% of all Charcot deformities.
- Type 3B - The posterior calcaneus.
- Type 4 - Multiple regions of the feet and/or ankle.
Some Facts Surrounding the Probability of Developing Gout Show Consistency
Men between the ages of 40 and 50 appear to be the top candidates. Women rarely show symptoms before menopause. Children and young adults are even less likely to be stricken with this painful illness. Heredity affects whether a person develops gout. Having a genetic predisposition accounts for about 18% of the cases.
The Progress of a Charcot Combined Could be Rapid and Depends Upon Several Variables
Any ability to perceive pain may lead to a more prompt diagnosis due to a patient's concern regarding their abilities to complete an average day. Complete loss of deep pain sensation may delay early diagnosis. Charcot joints are easily confused with osteoarthritis, which is taken care of much less aggressively than a Charcot joint.
The description of Charcot joints dates back to 1703 when neuropathic osteoarthropathy was first described by W. Musgrave. Charcot is credited with regard to his work in 1868 for describing gait anomalies of patients with syphilis (tabes dorsalis). Jordan, in was the first to describe a relationship of diabetes to neuropathic arthropathy.
- Other factors that may contribute to causing neuropathy, and subsequently, Charcot joints include;
- Alcoholic neuropathy Hereditary insensitivity to pain Pott's Disease (tuberculosis of the spine)
- Gout is known to be a rheumatoid form of arthritis that causes inflammation, intense pain, discomfort and swelling of the affected regions.
- Gout mainly tends to affect the joints, especially those of the lower body limbs, such as toes, heels, ankles, knees.
- In some cases, gout may cause inflammation of the elbows and hands wrists.
- Skin and soft tissue such as tendons and muscles can also be affected by the disease, losing their flexibility and elasticity.
- Gout is more likely to be created by men (almost 90 percent of individuals diagnosed with gout are male), usually after the age of 40.
- In some cases, women at menopause can be affected by the disease too.
- Gout rarely occurs to children and young adults.
- Arthritis is a group of conditions involving damage to the joints of the body.
- The most common form of arthritis, osteoarthritis is a result of trauma to the combined, an infection of the joint, or age.
The challenge in diagnosing this condition is the lack of signs and symptoms that are due to peripheral neuropathy. Peripheral neuropathy makes it impossible for the patient to be able to speak in terms that would be understood by the general population such as 'my ft hurt'. As a result, the physician needs to rely more on testing and less on the history and physical exam.
The main cause of gout is the clustering of uric acid crystals in the arteries, limiting normal blood flow and leading to inflammation. Due to either excessive production of uric acid in the body or renal insufficiency (sometimes the kidneys are unable to eliminate the surplus of uric acid), uric acid accumulates, crystallizes and deposits in different body regions. Food intake plays a major role in the development of gout. Some foods are rich in fat and purine, a substance that is synthesized by the organism into uric acid and therefore may aggravate the symptoms of gout. Smoking and the consumption of alcohol should be considerably reduced when suffering from gout, because these factors impact the secretion of uric acid, causing it's accumulation within the physique.
Saltzman, CL, Johnson KA, Goldstein RH, et al: The patellar tendon-bearing brace as treatment for neuropathic arthropathy: a dynamic force checking study. Foot Ankle 13: 14, 1992
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- Gout is considered to have a pronounced hereditary character.
- Research results indicate that some people who are afflicted by gout have a family history of the disease.
Surgical procedures for Charcot joints are often challenging not only due to the complexity of this condition but also due to the fact that these patients are usually poor surgical individuals due with other health problems (co-morbidity). Surgical procedure may include reconstruction of the arch and/or joint fusion. Often, surgical procedures are used to return the foot to a shape that can be accommodated by normal foot wear. Stage three Charcot deformities often result in lumps, bump and unusually shaped feet because of bone tissue alterations. Reshaping the feet may be used to remove a boney prominence on the top or bottom of the foot.
- Lavine LS, Grodinsky AJ: Current concepts review: electrical stimulation of repair of bone fragments.
- J Bone fragments Joint Surg Am 69: 626, 1987
One thing that we do know is that we have a larger aging population than in the past, and it continues to grow. The number of women who develop gout has doubled. Women need to consult with their doctors if they think that they are experiencing the pain of undiagnosed gout.. Simply because it has been traditionally associated with men and getting older, often women are not diagnosed as early as they could have been, postponing treatment. Colcrys 0.6mg tablets may be prescribed for prevention and treatment of gout.
- Low bone mass means that bones have less than the majority of select amounts of calcium and other minerals that make your bones strong.
- As a result of low bone mass, bones become weak and break, or can crack, break more easily.
- Bone fractures often occur from falling or tripping or other common accidents.
- Spine fractures can occur while doing daily activities without any trauma.
- Differential Diagnosis: The differential diagnosis for this condition should include;
- Arthritis rheumatoid and osteoarthritis Bone tumor Diabetic osteolysis
Other factors that may facilitate the development of gout are prolonged treatments with diuretics, previous surgeries, the presence of certain diseases that affect blood flow or extreme medical treatments such as chemotherapy.
- By aiming at the root of the problem and relieving the pain, try Nana Flex Or NanaFlex Cream .
- The anti-inflammatory natural oils in this blend are aimed at blocking the enzymes that elevate causing arthritis pain and inflammation.
- This also improves the flexibility of the affected joint.
Is Very Important to Control Gout Through the Means of an Appropriate Diet
It is best to keep away from cigarettes and alcohol, as these factors are known to worsen the disease. Drink plenty of water in order to facilitate the elimination of excessive uric acid (you should drink around 2 liters of water a day). Lastly, try to avoid a sedentary lifestyle; exercise regularly to keep your body in good shape.
Grady, J.F., et al: The use of electrostimulation in the treatment of diabetic neuroarthropathy J. Am. Podiatric Med. Assoc. 90(6): 287-294, 2000 Sinha, S., Munichoodappa, C.S., Kozak, G.P: Neuroarthropathy Charcot Joints) in diabetes mellitus. Medicine (Baltimore)
- Lavery La, Armstrong DG, Walker SC: Healing rates of diabetic person foot ulcers associated with midfoot fracture due to Charcot's arthropathy.
- Diabet Med 14:46, 1996
- Bassett CA, Mitchell SN, Norton L, et al: Repair of non-unions by pulsing electromagnetic fields.
- Acta Orthop Belg 44: 706,
About the Author:Jeffrey a
Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster can also be board certified in pedorthics. Doctor. Oster is medical director of Myfootshop.com and is in active practice in Granville, Ohio.
Nomenclature: reflex vasodilitation - increased flow of blood to an area within response to inflammation Rocker bottom foot - a dominance that forms on the sole or bottom of the foot as a result of the collapse of the arch
- Type 1 - Lisfrank's joint - 27-60% of all Charcot joint deformities of the feet.
- Type 2 - Chopart's joints and subtalar joints - 30-35%.
- The most common area of the foot to be effected by a Charcot joint may be the middle arch.
- Charcot joints can also develop at the rearfoot and ankle but are much less common.
- The most common cause of Charcot joints of the foot is peripheral neuropathy due to diabetes mellitus.
- Sticha RS, Frascone ST, Werthheimer SJ: Major arthrodesis in patients with neuropathic arthropathy.
- J Foot Ankle Surg 35: Frykberg RG, Osteoarthropathy.
- Clin Podiatric Med Surg 4:351,
- The classification proposed by Brodsky in 1992 consists of the location of the Charcot joint and it is commonly used in clinical practice today.
- Brodsky's classification is as follows;
Type 5 - The forefoot. Charcot joints are often not diagnosed until they create another problem that impacts a patients normal activities. These may be as simple as an inability to fit into shoes, or as severe as an infected ulceration of the foot. By this stage, the Charcot deformity has in all likelihood progressed to a point where there is massive displacement of the bones and joints along with multiple displaced fractures.
Arthritis is a Joint Disorder Causing Inflammation
A joint is an area of the body where two different bones meet. A joint functions to move the areas of the body connecting by its bones. Arthritis means inflammation of one or more joints. Arthritic diseases consist of rheumatoid arthritis and psoriatic arthritis, which are autoimmune diseases, septic arthritis, caused by joint infection; and the more common osteoarthritis, or degenerative joint disease. Arthritis can be caused from strains and injuries caused by rhythmic motion, sports, overexertion, and falls. Arthritic joints can be sensitive to weather changes. The increased sensitivity is thought to be caused by the affected joints increasing extra nerve endings in an attempt to protect the joint from further harm.
- Banks As, McGlamry ED: Charcot Fott.
- JAPMA 79:213, 1989 Pinzur Ms, Sage R, Stuck R, et al: A treatment algorithm for neuropathic (Charcot) midfoot deformity.
- Foot Ankle 14: 189, 1993
- Reinherz RP, Cheleuitte ER, Fleischle JG: Identification and treatment of the diabetic neuropathic foot.
- J Feet ankle Surg
Strong Bones Hold Up, Support Us and are the Structure With Regard to Our Muscles
Bones are a storehouse for extremely important minerals needed to live. Strong bones protect the heart, lungs, brain, and other organs from injury. Weak bones often effect in painful and weakening fractures. Hip fractures are the most devastating type of bone split and are the cause of almost 300,000 hospitalizations each year.
Fracture Gout Idiopathic edema Lymphedema Pseudogout Septic arthritis (infected joint) Soft tissue tumor Additional references include;
- Pap J, Myerson M, GirardP, et al: Salvage with arthrodesis in intractable diabetic neuropathic arthropathy of the foot and ankle.
- J Bone Joint Surg Am 75:1056, 1993
- Eichenholtz SN: Charcot Joints, Charles C.
- Thomas, Springfield, Il 1966 Giurini JM: Applications and use of in-shoe orthoses in the conservative administration of Charcot foot deformity.
- Clin Podiatric Med Surg 11: 271, 1994
- As the number of women who have gout increases, there are other complications that can also arise.
- For instance, women with gout may be 39% more likely to have a heart attack based on some studies.
- However, the rise in the risk of heart attack for men with gout is far less.
1966 Eichenholz proposed a classification of Charcot joints which is broken down into three distinctive stages. Stage one, or the development stage, shows debris surrounding the joints on xray. Stage one can develop over a period of days to weeks and it is radiographic change that occurs in response to unperceived trauma. Stage two is the coalescence stage. In stage two, the bone starts to heal with absorption of debris and healing of large fracture fragments. Stage three, often called the reconstruction or reconstitution stage, note a reduction in bone turn over and reformation of stable bone structure. Stage 0 was added in 1999 by Sella and Barrette to include patients who exhibit clinical symptoms of Charcot arthropathy but have yet to show radiographic changes.
Diabetes mellitus Tabes dorsalis (neuropathy caused by syphilis Hansen's Disease (Leprosy) Tumors of the spinal cord Degenerative change from the spinal cord or peripheral nerve Amyloid Familial-hereditary neuropathies including Charcot-Marie Toothe Disease, Hereditary sensory neuropathy and Dejerine-Sottas Illness Pernicious Anemia.
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- Any condition that plays a role in the loss of sensation of the foot may be considered a cause for a Charcot joint.
- Some of those conditions include;
The most common complicating factor of a Charcot joint of the foot is the prominence that develops on the bottom of the foot, referred to as a 'rocker bottom' foot. This problem occurs as the bones of the arch collapse. In an advanced rocker bottom foot, the inability to feeling pain becomes a complicating factor for the skin. As the bone places more pressure on the skin, the skin begins to ulcerate and becomes infected.
- Did you know that there are more than 100 types of arthritis?
- Common arthritis symptoms of inflammation, pain, and stiffness are usually caused by degenerative arthritis.
- Other types of arthritis include rheumatoid arthritis and gout.
Symptoms: The symptoms of Charcot joints vary based upon the location and severity of the problem. The first sign is localized edema swelling) of the joint or joints. The edematous area may exhibit increased temperature change. Often, the first noticeable symptom that a patient with advanced peripheral neuropathy will notice is the fact that their shoes have become tighter or these people have difficulties appropriate into a pair of shoes that have fit well for some time.
- People who suffer from gout may experience sudden, unexpected pain episodes that tend to reoccur periodically.
- This may be a first sign of chronic gout.
- The pain may also be more intense during the night in the case of some people who suffer from gout.
- Another type of gout, referred to as pseudogout, occurs due to the accumulation of crystallized calcium in the joints, instead of uric acid.
Some people who have chronically high blood levels of urate (commonly referred to as uric acid) will go on to develop gout, but not everyone. In fact, up to approximately 2/3 of the population who have higher levels of urate do not become victims of gout. Why? No one really knows for sure. Could women have less tolerance for higher levels of uric acid since before menopause their levels are generally much lower? Once again, the jury is out on this one.
Weak Bones Should Not Just be Excused as a Natural Part of Aging
Strong bones begin in childhood. People of all ages can improve their bone health. Bone is connective tissues that contain a hardened matrix of nutrient salts as well as collagen fibers. Its cells include osteocytes, which are embedded within lacunae, and the free-roaming osteoblasts and osteoclasts. Bones support body structures, protect internal organs, and in conjunction with muscles facilitate movement; are also involved with cell formation, calcium metabolism, and mineral storage. The bones of an animal are, collectively, known as the skeleton.
All Arthritides Attribute Pain
Pain patterns may be different depending on the arthritides and the location. Rheumatoid arthritis is normally worse in the morning and related with tightness, in the early stages, people often have no symptoms after their morning shower. In the aged and children, pain might not be the most important presenting feature, the aged person simply moves less, and the child refuses in order to use the affected appendage.
- Obesity is another important factor that leads to the development of gout.
- The organisms of overweight people tend to create more uric acid.
- Obesity also increases the risks of injury at the level of the joints.
- Cleveland M: Surgical fusion of unstable joints due to neuropathic disturbance.
- Am J Surg 43: 580, 1939 Wilson M : Charcot foot osteoarthropathy in diabetes mellitus.
- Mil Med 156: 563, 1991
- Steven Johnson is interested in maintaining a vital, active, and healthy lifestyle.
- For information and products on natural pain relief and other life-enhancing nutrients please visit his website Alternative Health Supplements.