Chronic tophaceous gout is a metabolic disorder and the most severe form of gout that can manifest as acute or chronic arthritis form. It brings sudden and intense attacks of joint pain just like the way it happens in gout which is the most common type of inflammatory arthritis. The ailment frequently occurs after the patient has seen 8 to 10 years of recurrent gout. Identified by the deposition of monosodium urate crystals in connective tissues and kidneys, Chronic tophaceous gout is associated with renal impairment, obesity, hypertension, and sometimes due to family history. This ailment can either occur as a standalone disease or can develop as an aggravated form of arthritis. The deposition of crystals in joints, bones, soft tissues, and kidneys causes severe inflammation and pain.

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How Is Chronic Tophaceous Diagnosed?

Chronic tophaceous gout is characterized by destructive polyarticular joint involvement (Polyarticular joint pain involves five or more joints which can either be inflammatory or noninflammatory) and the formation of uric acid masses called tophus under the skin and tissues. Rarely an early sign of initial gout stages, tophus tend to occur in patients who have had gout for many years with recurring flares. Tophi are large, visible bumps made of urate crystals that get formed in joints, elbows, hands, feet, or the outer edge of the ear. Most tophi tend to be easy to locate but some little versions of tophi can only be detected with an MRI or an imaging test.

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What Causes Tophus Formation?

Someone who has been diagnosed with gout but rarely has a flare-up with an attack once or twice a year will less likely to develop tophi. But these nodules may occur if you have had frequent and severe gout attacks. Frequent episodes of gout are an indication that your uric acid levels are consistently too high and when these flare-ups keep occurring, these nodules start to build up and progress toward chronic tophaceous gout. More often, if your gout goes undiagnosed or is not well-controlled, the patient may start to experience complications and tophi is one of them. While it may happen to anyone with gout, it is more likely to occur if the prescribed medication is not taken and uric acid levels are not controlled in time.

Symptoms

The following symptoms are commonly seen in patients suffering from chronic tophaceous gout:

• Tenderness, and warmth at the tophus location
• Discomfort when using the affected joint
• Severe pain in the affected joint after the attack begins
• Redness and chronic inflammation
• Discoloration of the skin
• Tenderness in one or more joints

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Treatment For Chronic Tophaceous Gout

The best way to treat any form of gout is to catch hold of the ailment in the beginning. Through a specific diet and by making long-term lifestyle changes uric acid levels can be managed and kept in control. In advanced stages, uric acid-lowering medications are the first line of treatment for tophaceous gout and other gout forms. It can be of great help to quickly lower levels of uric acid in the body thus preventing flares and long-term damage from gout and its complications. The treatment aims to decrease serum uric acid levels which eventually helps to alleviate tophaceous gout symptoms. People with large, numerous, and large tophus formations may have to undergo surgery to get them removed besides repairing the damage they have caused to the joints.