1.What is gout stone
Gout stones, also known as gout nodules, are white crystals that precipitate in a certain part of the body due to excessive elevation of uric acid in the blood, exceeding its saturation level, just as white deposits appear at the bottom of a glass of saline when the amount of salt exceeds a certain limit. Gout stones can be formed in almost all tissues of gout patients except the central nervous system.
Some gouty stones cannot be seen with the naked eye, but can be seen as white needle-like crystals under a polarized light microscope. These tiny crystals can trigger an attack of gouty arthritis, and can also cause destruction of joint cartilage and bone and fibrosis of the surrounding tissue, resulting in chronic joint swelling, pain, stiffness, deformity, and even fracture. Some gout stones are deposited on the surface of the body, such as around the ears and joints, and can be seen with the naked eye. Some gout stones are also deposited in the kidneys, causing kidney stones and inducing renal colic.
2.Possible sites of gout stones
Gout nodules on the surface of the body tend to occur on the extensor side of joints, tendons and the surface of bony prominences. The common site is the external ear, especially the ear wheel (typical) and the opposite ear wheel are common; followed by the first metatarsophalangeal joint of the foot, ankle, fingers, wrist, ulnar hawk, knee capsule and Achilles tendon.
3.Characteristics of gout stone
(1) Sesame-egg-sized, yellowish-white nodules protruding from the skin.
(2) The texture is hard.
(3) The surface is thin, and the white paste (uric acid crystals) is discharged after rupture, although it does not heal for a long time, but rarely secondary infection, because uric acid can inhibit bacterial growth.
(4) The number varies, generally 1-10.
4.X-ray performance of gout stone
Pure uric acid stones, also known as soft stones, are not detected on plain X-rays because X-rays can pass through them. However, the presence of stones can be confirmed by pyelogram; if the stones contain calcium salts, they are hard stones and can be seen on plain X-ray. It is worth noting that in 40% of patients, urinary stones can precede gouty arthritis, even by 10 years, so patients with urinary stones should be alert to the presence of gout.
5.The relationship between gout stone and uric acid salt
The higher the blood uric acid level, the higher the chance of gout stone. Gout stones can occur in 50% of patients with blood uric acid levels above 535.32umolML. In addition, 20% of patients with gout stones are prone to urinary tract stones. Therefore, it is very important to control the blood uric acid level to reduce the formation of gout stones and reduce the damage to the kidney.
6.The relationship between gout stone and the course of the disease
Gout stones mostly occur in patients who have been suffering from gout for about 10 years. The time between the first attack of gout and the formation of gout stone is 4-42 years.
The time between the first gout attack and the formation of gout stones is 4-42 years, with an average of 11.6 years. The longer the duration of the disease, the more gout stones there are, the incidence of gout stones is about 10% for those with <5 years of disease, 55% for those with 5-20 years, and 70% for those with >20 years of disease. The formation of gout stones seen by the naked eye is a sign that the course of gout has become chronic.
7.How to deal with gout stone
(1) Alkalinize urine: Alkalinizing urine is beneficial to the dissolution and excretion of uric acid salts, especially for the prevention of uric acid kidney stones and gouty nephropathy. This includes eating more alkaline food and rational application of alkaline drugs, but this is often not taken seriously.
(2) Treatment with uric acid-lowering drugs:There are indications for uric acid-lowering drug treatment. It is generally believed that uric acid-lowering drugs should be applied in the following cases: acute gouty arthritis with more than 2-3 episodes per year, with gouty stones, manifestations of kidney damage, or those whose blood uric acid is still significantly elevated by dietary control.
(3) Surgery: If the gout stone is not large and does not affect the function of organs, surgery is not necessary because surgical removal of gout stone does not cure the disease, but only in the following cases: gout stone affects the function of joints or compresses nerves; removal of necrotic fingers (toes) due to uric acid erosion or correction of deformed joints; removal of huge gout stone to reduce the burden on the kidneys. Surgery should be performed after normalization of blood uric acid. To prevent surgery-induced acute gouty arthritis, it is best to take non-steroidal anti-inflammatory drugs before and within one week after surgery.