Dr. Naval Mendiratta
Rheumatology
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Patient's Query
Hello doctor,
I am suffering from chronic gouty arthritis. It started ten-plus years ago and now progressed to every joint in my body with multiple joint attacks at once. I have constant pain in my joints, even if there is no attack. The attacks jump from joint to joint nonstop. I have seen many doctors; they can only give me shots and a prescription for Indomethacin, which is not working for me as it has been taken for more than 10 years. I have changed my diet to exclude a lot of food and drinks with sugar, purines, citrus, salt, etc. Right now, the pain is in my ankle, knees, and left arm (shoulder, rotator cuff, elbow, wrist, thumb, and neck). I have been very depressed and go to bed in pain and wake up in pain daily. My daily functions are limited.
Hi,
Welcome to icliniq.com.
I have gone through your history, and it is a bit unusual for a 40-year-old to have polyarticular gout, that is involving a lot of joints. Firstly, I would recommend you visit a Rheumatologist near you to sort it out. Meanwhile, first, we should rule out if it is gout only or some other form of arthritis, which are intermittent sorts like gout such as Palindromic Rheumatism. I would like to know your last uric acid levels and if you have ever got rheumatoid factor (RF) and Anti-CCP (anti-cyclic citrullinated peptide) done. If it is gout, then Indomethacin is just going to help the attack. You need to start on proper medications. The treatment would be to start tablet Zycolchine (Colchicine) along with drugs like Febuxostat or Allopurinol.
Thank you.
Investigations to be done
Differential diagnosis
Treatment plan
Preventive measures
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