Gout Elbow Symptoms, Pictures and Treatment

Elbow Gout is a disease of metabolic origin, marked by accumulation of urate crystals in the joints and soft tissues. This inflammatory disorder of arthritis causes pain, swelling, and inflammation of the elbow joint, or olecranon.

Gout of the elbow is caused by the breakdown of purines, leading excessive uric acid in the blood. This is caused by the kidney's being unable to sufficiently excrete uric acid from the body. Chronic conditions, like diabetes, sickle cell anemia, and kidney disease, are factors that are conducive for development of gout. Obesity is another factor for gout.

The disease presents in four stages: asymptomatic (no symptoms), acute, intercritical, and chronic.

A gout attack of the elbow can happen rapidly and most likely to occur at night. It is extremely painful. The foot is painfully swollen, red, and tender to the touch.

The painful gout attack of the elbow usually resolves within 72 hours, but may recur at any time in the future. The next attack may last longer or never return again.

Risk factors include:

• Men


• Postmenopausal women


• Use of alcohol


• Being overweight

Joints of involvement include:

• Hips


• Knees


• Ankles


• Feet


• Shoulders


• Elbows


• Wrists


• Hands

The great toe (podagra), knee, or ankle joints are commonly affected, and can be combined with swelling, stiffness, warmth, and redness.

Tophi: Is the accumulation of urate crystals in the soft tissue, appearing as lumps, surrounding the affected joint, and may drain a chalky material.

Diagnosis:

Physical assessment of the olecranon (elbow) joint may show acute arthritis. Biopsy of the synovial fluid, aspirated from the elbow joint using a needle, will show urate crystal formation. Elevated uric acid levels will also be present in the blood. X-rays will most likely be normal, as an acute attack will not show any joint abnormalities.

Diagnostic Testing:

• Uric acid - urine


• Synovial biopsy


• CBC and differential

Treatment:

The goals of treatment are focused on pain and inflammation reduction, as well as medications to prevent further attacks. Medications include:

Colchicine: Reduces pain, swelling, and inflammation. Successful pain management occurs within 12 hours of initiating treatment, with total relief in two days. However, colchicine does not decrease uric acid levels in the blood, but used in conjunction with allopurinol helps to avoid future attacks.

NSAIDs (non steroidal anti inflammatory drugs) are effective for management of pain and inflammation.
Corticosteroids injected into the inflamed joint is also effective for pain management.
Codeine or other analgesics may be prescribed to reduce pain.

While it may not always be possible to prevent the first attack, subsequent attacks can possibly be avoided by following a healthy diet, taking medications as prescribed, drink plenty of water, and following your doctor's orders.

by Barb Hicks, RN