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HomeAnswersOrthopedician and TraumatologygoutAre joint and knee pain symptoms of gout?

Is joint pain a symptom of gout?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sneha Kannan

Published At January 12, 2016
Reviewed AtJuly 25, 2023

Patient's Query

Hi doctor,

Over the last few weeks, my wife is suffering from joint pain in the foot and right knee. When I search for this problem online, I found it as a symptom of gout. Can you please explain to me about gout?

Hi,

Welcome to icliniq.com.I have gone through your query and also looked at the pictures (attachment removed to protect patient identity). Initially, I would like to throw some information about gout. It is a condition of altered purine metabolism in the body in which crystals of monosodium urate deposit in the joints leading to inflammation comprising of severe pain, redness, local warmth, etc. In the foot, the great toe is usually affected although conventional gout does not easily involve the knees. There are ways to keep uric acid value low in your body. General recommendations are:

  1. Reduce intake of alcohol, red meat, rice and other purine rich sources in your diet.
  2. In order to excrete more uric acid from your body increase your water intake.
  3. To reduce uric acid value in the body eat fresh fruits, citrus fruits and cherries as well.
  4. Maintaining normal body weight will also help you with this issue.

Nowadays there is a medication by the name of Febuxostat which helps in lowering uric acid levels in the body. But, kindly check out that it suits your body. Although I have provided information about gout in detail, it may not be necessary that she is suffering from gout as the whole foot appears to be swollen. Anyway, kindly get some blood tests done immediately from a good pathology laboratory and send reports across to me. Tests are preferable to be done in an empty stomach. Kindly start with an anti-inflammatory medication which suits her body. Give intensive ice packs and keep the limb elevated at night while sleeping to manage gout. Also, can you kindly tell me whether she is having any systemic symptoms like a fever? Can you send me a picture pointing to the exact site of pain in the foot and also the knee? Does she normally take medications for any other pathology? What has been her past medical history? Does she suffer from any significant allergic history?

Thank you.

The Probable causes

Metabolic causes. Infection.

Investigations to be done

1. CBC (complete blood count). 2. ESR (erythrocyte sedimentation rate). 3. CRP (C-reactive protein). 4. Serum uric acid. 5. KFT (kidney function test). 6. Thyroid profile. 7. RBS (random blood sugar).

Differential diagnosis

1 .Gout.

2. Cellulitis foot.

Patient's Query

Hi doctor,

We have already done all the tests twice and consulted two doctors about this issue. But, did not get any positive results. When she takes the Chymoral Plus tablet it gets relaxed for 12 to 24 hours. We already get the Febuxostat tablet in her second report and the uric acid level is going low, but no benefit in pain. First-time uric acid in blood was high. I have attached the second test results now. Please go through it and tell me if any other things you need from my side.

Hi,

Welcome back to icliniq.com.

I have gone through the test reports (attachment removed to protect patient identity) but these are not enough. As I have written, I will further need ESR, CRP, thyroid profile, KFT including serum electrolytes. Also kindly send me the detailed answers to my questions and also the relevant clinical pictures. I have to rule out infection here although the total blood counts are fine. I have also gone through the medications. They are fine but few appear to be unnecessary like Osteocerin, in my opinion, is not required at this age. There is no anti-inflammatory medication here which I should be able to tell you if her KFTs are fine. Also kindly mention the date on which these tests have been done as I am not able to see the exact date of these investigations.

Thank you.

Patient's Query

Hi doctor,

This problem started around four months back when my younger kid sat on my wife's knee. Her knee pain started after that incident. First prescription I have sent you in this attachment. Then after a few days, we consulted another doctor who prescribed some medicine and also asked for an x-ray. In her X-ray report doctor said nothing to worry about. But, there is a symptom of arthritis, and had given some medicine related to arthritis. After all this, she did not get to relax from pain. Then after a few days, she walked more than enough and then felt a little relaxed because of the medicine. Then she felt that the problem has increased in her feet and had no positive result yet. I have attached the recommended blood report. She is already taking the tablet Chymoral Plus. Also, we are doing an ice pack and we have put a pillow below the limbs. Yes, last week she is continuously suffering from a fever, especially in the evening. I have attached the photos of the exact pain site. She did not take medicine for any other problem.

Hi,

Welcome back to icliniq.com.I have gone through your entire spectrum of records including images and blood tests (attachment removed to protect patient identity). As I have told you, ESR is slightly rose which is a marker of inflammation. I have also asked you to get CRP, thyroid profile, and KFT. So, I will need reports of them as well. You have also mentioned a fever for one week continuously. So, kindly get a Mantoux test done. Also, you are taking Chymoral Plus (a combination of Diclofenac potassium and Trypsin) which is a decent medication with ice packs. You have sent me snaps of foot but you have also written that she has knee pain for which no clinical pictures are available. Can you also tell me, does she feel any morning stiffness? What is the range of fever? Have you recorded that on a daily basis? How severe is her pain on a scale of 1 to 10?

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Akshay Kumar Saxena
Dr. Akshay Kumar Saxena

Orthopedician and Traumatology

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