An inherited condition of elevated levels of uric acid in the blood. This condition causes the formation of small crystallizations of the uric acid that accumulate in the joints. The result is a painful inflammatory response in the affected joints. After the hands and feet, the knee is the third most common site of an episode (Goodman).
Risk factors: (Goodman)
Patient will complain of an acute onset of arthritic like symptoms in one joint. They are likely to be awakened from sleep by the intensity of pain in this joint. Pain will be greatly intensified by even light touch or restrictive clothing. Patient may express the feeling of chills (Goodman).
The affected joint is likely to be observably red and swollen. The patient may present with a low grade fever. If Tophi are present, the clustering of urate crystals under the skin, these can be palpated and sometimes erupt through the skin emitting a chalky substance (Goodman).
If you suspect that your patient is experiencing an acute episode of Gout, refer the patient to a rheumatologist. If these patients are seen in physical therapy, it would likely be to counteract the deconditioning or decreases in functional activities that may occur due to inactivity during a flare up.
One episode of gout pain usually lasts anywhere from 1-2 weeks. Episodes are likely to repeat themselves, especially if the condition is poorly controlled. As the disease progresses, episodes are likely to affect more than one joint at a time (Goodman).
- Goodman, C.C., and T.E.K. Snyder. Differential Diagnosis for Physical Therapists Screening for Referral. 4. St. Louis: Saunders Elsevier, 2007. Print.
- Image from: http://goutpictures.net/knee-gout/what-causes-gout-in-the-knee (accessed on 06-30-12)