In its first onslaught, gout usually attacks the big toe. In fact, approximately 90% of people who develop gout develop gout symptoms in their big toe. However, it is possible for gout to affect other joints. Whether it occurs in the initial attack or in later recurrences, gout can also be present in the:
Why does gout affect other joints? Gout occurs in other parts of the body for the same reason as it occurs in the big toe. Essentially, the body has a build up of too much uric acid. The excess uric acid develops into crystals that are often deposited into joints.
Regardless of what joint gout affects, the first attack almost always strikes at night and the infected area becomes inflamed, red, swollen and incredibly tender and painful. Most initial gout attacks clear up with in 3 – 10 days and more than half of the people, who have experienced an acute attack of gout, will have another attack within the year. If action isn’t taken to prevent gout, over time, the recurrence of gout may become more frequent, last for longer periods of time and affect more joints.
For those gout sufferers who experience frequent lingering attacks, their gout condition will eventually become chronic. Chronic cases of gout involve more joints, and the constant presence of uric acid crystal deposits within the joint, and the soft tissues that surround it, leads to persistent inflammation. Chronic inflammation is a sign that destructive changes have occurred within the joint.
Furthermore, long-term cases of severe gouty arthritis will affect the fingers and can cause different joint to be inflamed simultaneously. This often occurs in elderly gout sufferers, and is a type of gout classified as polyarticular gout. In addition, those who failed to treat their gout condition, and experience regular attacks, will usually develop the most serious case of gout known as Chronic Tophacerious Gout, which usually occurs 10 – 20 years after the initial attack.
Chronic tophacerious gout is characterized by the formation of tophi. Tophi are crystallized uric acid deposits that can be found directly under the surface of the skin in the joint area that is affected. The presence of tophi creates a lump. Small tophi may not be obvious, but they often appear as mobile lumps. Larger tophi make its presence known by poking through the skin and forming hard chalk-like nodules. Tophi nodules can appear on the: Outer ridge of the ear, forearms, elbows, hands, fingers, knees and feet.
Tophi nodules can become painful, especially if they are close enough to a joint that they restrict movement and cause stiffness. However, they usually are not sensitive to touch. Tophi within a joint will eventually cause the bone and cartilage to erode. Moreover, if the tophi are particularly large, permanent deformities can result. Chronic tophacerious gout is the most difficult form to treat.
As you can see, even though it isn’t common during the initial attack, gout symptoms can affect almost any joint, and the risk of it going beyond the big toe increases with recurrences and age. Therefore, if you suffer or have suffered from gout, you need to make sure that you keep your uric acid in check to avoid future attacks and protect the health of your other joints.