aching joint

[aaron]

hi i wrote about my major gout attack in april. things are ok but now i have this fairly constant ache in my big toe joint. also it seems to be getting larger as well. if i push on it, it hurts a little as well. nothing crippling as before but not gone away. does anyone notice their joint getting bigger? if your uric acid is lower should this disappear? i'm nervous about this. is this a sign of tophi/ does allopurinal reduce joint swelling/ thanks for any info.. aaron

[odo]

Yeah, I call mine “Osama Bin Laden's Cave”  No matter how long I've been gout free, I know that SOB is lurking in there somewhere

It's hard to give a definitive answer to your question; with every attack there's bound to be an additional build up of urate deposits in & around the joint. If you're on AlloP, then in theory these deposits should eventually dissolve and be excreted, but there may also be some permanent joint changes and build up of connective tissue which will never go away.

The important thing is to keep track of your SUA levels and maintain them below 6mg/dl because even though you're not getting attacks your levels may be high enough to be laying down urate which will eventually precipitate an attack & cause more joint damage. AlloP/Uloric is almost certainly the only effective way to do this.

[zip2play]

I think there's a residual amount of urate deposited with EVERY attack and this is walled off by the body outside the joint and outside the reach of the bloodstream. Think of it as a scar. I am certain there are tophi that form that are completely impervious to any intervention except surgery…they are FOREVER.

I have a tiny painless tophus (about the size of a lentil near the far end joint (distal?) of my little finger. It formed without ever causing me any pain at all, probably as a result of being the coldest joint in my body.

My right bunion is slightly larger than my left and that was the site of my ONE murder attack 15 years ago. So I guess it is likely to remain larger until the day I die…and then some.

I have had only one tophus resolve…a medium sized one on my thumb. Over the course of a year, it worked itself out under the nail (causing a huge painful lump under the nail.) It was amnazing to watch the inexorably  slow progression as my body tried to get rid of it. Finally at mid nail I grew impoatient and pierced the nail with a red hot paper clip and the wound oozed a white chalky cream for about a week. I was  CURED: tophus GONE!.

[hansinnm]

zip2play said:

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I second, confirm, support, and whatever else, each of Zip's statement, observation, and operation.

[Author]

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