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Hello,

Just thought I'd run this past a few people.

I recently spoke to a client who suffered what his doctor believed was a mildly sprained ankle.

This then became much more painful and within a couple of days, rather than the sprain easing, it became unbearable and the patient could not rest the foot/ankle in any comfortable position claiming it felt broken, he lost three or four nights sleep due to excrutiating pain.

He then visited his doctor again (on crutches) who sent him for an x-ray which returned no signs of fracture or break.

Ibuprofen and Cocodamol were prescribed which eased the pain slightly but not much. This took around 10 days to fully ease, and the client complained about the feeling of slight gout in his first mpj for a week or so after this. His doc gave a full blood test and there was a slight increase in his uric acid levels.

I am wondering, as there has been a history of gout with this patient before whether the gout had taken advantage of the injury and compounded the problem in his ankle.

Has anyone else experienced such issues.

 

The uric acid levels in the blood are pretty meaningless unless there is a chronic hyperuricaemia - the problem with bloods for this is that the higher uric acid levels have been reduced by depositing the crystal in the joint(s), so no show up. Get the doc to prescribe colchicine for a couple of days - if that helps dramatically, then there is a very high probability of gout.

 

Hi Craig,

Thanks for your reply, when the client first had gout three years ago it lasted around a week in his right 1st MPJ, The doctor advised the client to wait for a couple of weeks before he had a blood test (this would tally with what your saying to allow the uric acid levels to return to their usual level) and on that occasion the uric acid levels were high. But on the next occasion a different doctor took the bloods during the gout attack and the uric levels were lower than the first instance.

I will advise the client to go to the doctor and discuss the possibility of being prescribed colchicine for a short period.

Thanks again for your advice.

 

Lilypad, after checking the contraindications.
I'm one of the zillion chronic renal people that can't have colchicine, and can only have allopurinol in low doses also.

 

My husband's very first gout attack was in his ankle. I talked him into going to the GP (because I suspected gout) but she said he'd sprained his ankle (even though there was no history of injury) - she told him that I should "stick to podiatry". After prescribing anti- inflammatory tabs and subsequently experiencing a few more attacks, he was finally diagnosed with gout. He now gets most attacks in his ankle and only rarely in 1st MPJ.

 

Thanks for the posts, my client's gout had cleared up... however, it flared again in the ankle and after admitting to drinking a bit too much (mainly red wine). I know alcohol can be a trigger for gout, I applied some gentle massage in the area and it seemed to improve things slightly. They are also trialing taking cherry juice combined with... reduction in alcohol :)