Osteoarthritis and Gout

[HiveMind]

Hello All,

Well, as I don't EVER do things by half, I've recently managed to "acquire" Osteoarthritis AND Gout. Neither of which I would wish on my worst enemy!

After 5 weeks of an extremely painful knee I've now started with my (2nd) bout of gout (in my toes). I've been given Colcocine (hopefully I've spelt it correctly) which helps but only slightly. This is the 2 bout of Gout in as many months. I'm now virtually housebound because I can't walk or drive. 😢

Does anyone else suffer with these conditions? Are they a common in people with Vasculitis? How do you cope? Along with all my other Vasculitis symptoms, this is really starting to get me down. My very sporadic social life is dwindling further down as I can't join in with outings etc.

I just wanted some (perverse!) reassurance that I'm not on my own!

Sorry for the moaning style of this letter, hopefully it hasn't ruined your Monday! 😬

[Albasain]

Sorry to hear that you are suffering so.

I have had similar complaints, firstly diagnosed as tendonitis (By GP), then as false gout by rheumy consultant while I thought it was more akin to Tenosynovitis which was confirmed by another consultant as Migratory Acute Tenosynovitis.

So together with Rheumatoid vasculitis, mono neuritis multiplex and now Migratory Acute Tenosynovitis I'm having a jolly old time of it too.

It appears to be all connected to the underlying cause of vasculitis per se.

So far, apart from some seriously painful episodes in May/June this year it seems to have passed with no change or additions to my medications apart from a temporary increase of Preds.

So there is always hope that it will get better for you too.

Best wishes.

[HiveMind in reply to Albasain]

Thanks Albasain! I'm hoping my "painful episodes " will soon pass too! 😉

[PMRpro]

Have you had the diagnosis confirmed by aspiration of joint fluid? Or is it just based on a high blood uric acid level? There are two manifestations of gout - gout is caused by monosodium urate monohydrate crystals; pseudogout is caused by calcium pyrophosphate crystals and is more accurately termed calcium pyrophosphate disease. Without aspiration you don't know which it is.

Chicken and egg here though:

"Patients with gout, particularly women, are at increased risk for vascular disease, according to a retrospective cohort study of 8386 patients with gout and 39,766 matched controls. Multivariate analysis showed that women with gout had a 25% increased risk for any vascular event compared with women without gout (hazard ratio [HR], 1.25) and increased risks for any coronary heart disease (HR, 1.25) and peripheral vascular disease (HR, 1.89)."

Someone else on one of the PMR/GCA forums was saying they had gout but I can't remember who it was now - but there are others BB!!!!

[HiveMind in reply to PMRpro]

Hi PMRpro,

I've only been diagnosed because of an X-ray. No biopsy or Uric acid test.

Everyone just seems to be content to take it as read that the X-ray shows (early stage) osteoarthritis. Should I push for a joint biopsy and/or a Uric acid test?

I already have vascular issues; my heart was damaged by the CSS. 😟

Thanks for your comments 👍

[Tony-LakeDistrict]

Hi, welcome to the fun & games

I've been on treatment for M.P.A for nearly 8 years, It's all the little surprises along the way that catch us out.

3 years ago I started to have `gout'. Prescribed Colcocine, but side effects for me not good.

Now on Allopurinol full time every day & no noticeable side effects, & no hint of Gout.

Check out foods that trigger gout, though I have found once you have things under control, then you can indulge a few noughties.

I have not had an attack for over a year.

As for your knee, it's a long shot, but if you haven't had one, ask if you could have a bone density check.

All the best

Tony

[HiveMind]

Hi Concerned,

I'm fairly certain I don't have an excess of any of those things. 👍

[HiveMind]

Hi Tony,

I know what you mean about the "Little surprises"! 😬

I've had a bone density check and apparently all is well in that regard.

Is Allopurinol safe to take long term?

Thanks for your reply. 👍

[PMRpro in reply to HiveMind]

This seems quite easy to read (to me at least, can't remember your background) - and suggests a plain x-ray isn't a lot of use.

pmj.bmj.com/content/81/959/...

Allopurinol is to reduce the serum urate level - but they suggest it only makes sense if you get repeated episodes on a frequent basis. There are a few things that can trigger isolated attacks - so they need sorting out.

The article recommends some reading matter and gives links for the gout society and ARC.

[HiveMind in reply to PMRpro]

Thanks PMRpro,

I'll take a look at the BMJ link. 👍

[Tony-LakeDistrict in reply to HiveMind]

What Ho,

as far as I know, I'm on Allopurinol for the rest of my, hopefully long time.

It might be helpful to check out SymptomFind their does & don'ts on the food front can surprise you,

I found a hotwater bottle on the feet helpful, though I know some people found to the contrary.

I hope walking on broken glass ,becomes a distant memory in the very near future

All the best Tony

[PMRpro in reply to Tony-LakeDistrict]

Is that with just a single joint affected by gout?

In the early days of PMR when I stood up after sitting for a while my feet felt as if I was walking on a mixture of broken glass and sharp gravel! Quite a few people have mentioned similar experiences.

[HiveMind in reply to PMRpro]

Yes, just a single joint, my toe (the one next to my big toe). To be perfectly honest I'm completely baffled as to whether it is actually gout and not osteoarthritis (I have osteoarthritis in my knee - same leg). How do I tell the difference?

[PMRpro in reply to HiveMind]

Joint aspiration and blood urate levels are a good start if they haven't been done. I do get fed up with doctors saying it's this that or the other without using the diagnostic facilities available to them when there are a few things it could be. Darn them - they don't have x-ray eyes even if they think they do.