Gichtfinger: What to do?

In the metabolic disease gout it comes through deposits of uric acid crystals in the joints to a painful joint inflammation. Although the metatarsophalangeal joint of the big toe is most commonly affected, in about five percent of cases, there is also a gout attack on the finger joints.

A gout finger is often particularly uncomfortable, since the mobility of the whole hand can be painfully limited. Here you can find out which signs point to a gout finger and what you can do to prevent gout on the finger.

Increased uric acid as a cause

Gout (arthritis urica) is the symptom of a pathologically increased uric acid concentration in the blood (hyperuricemia). If the level of uric acid rises rapidly - for example after a banquet or after an excessive consumption of alcohol - precipitation of uric acid crystals in the synovial fluid occurs. The result is a sudden inflammation of the affected joint.

The widespread assumption that it is possible to get gout by "breaking a finger" is thus not correct. Here you will find more information about the causes of gout.

Gout finger: Rare form of gout

In about 80 to 90 percent of cases, a gout attack on a joint of the lower limb occurs - a gout finger is therefore more of a rarity. Most commonly affected is the metacarpophalangeal joint - this form of gout is also called Chiragra. Less often there is gout on the finger joints of the other fingers.

It is not known exactly why gout on some fingers occurs in some people and not in others. A possible cause of a gout finger is a prior damage of the finger joint - for example, by a previous injury or osteoarthritis - which causes the uric acid crystals to preferentially deposit on this joint.

Sudden symptoms

In a gouty finger, the characteristic signs of joint inflammation suddenly appear: the joint is reddened, overheated, swollen and hurts badly. Mostly, the flexibility of the finger joint is limited due to pain and swelling.

The finger can also be very sensitive to touch, so even a light touch as through a blanket is unbearable. In most cases, fever and a general feeling of illness are added.

Typically, the symptoms occur unexpectedly in full health - often the seizure begins at night or early in the morning. After a few days to weeks, the symptoms disappear completely and the finger can be moved back to normal.

Gitttophi: signs of chronic gout

If gout is not treated consistently, the disease can become chronic. Then uric acid deposits can cause so-called gout tophi. These are small, painless lumps that form in soft tissue, cartilage or bone.

Apart from the fingers, the tophi can also occur on the feet, the pinna or the elbow. In addition, longitudinal grooves in the fingernails may indicate a chronic gout disease.

Chronic course rare

In rare cases Gichttophi can form on the tendon sheaths of the hand. This can then result in painful tendonitis or even a carpal tunnel syndrome.

Signs include pain in the fingers or wrist, and a tingling or numbness in the thumb, forefinger and middle finger. Due to the usually early onset of therapy, however, a chronic course of gout is nowadays quite rare.

Diagnosis: uric acid levels are not always increased

Since a gout finger is a rare form of gout, the diagnosis is not always close. All the more important is a targeted diagnosis to exclude other causes of joint inflammation.

In addition to the symptoms provide possible triggers of the attack such as heavy eating, drinking alcohol or a fasting first indications of the disease. A blood test will usually show elevated levels of inflammation, but the level of uric acid may be normal in the acute stage and should be checked again after two to four weeks.

Joint puncture in exceptional cases

In unclear cases, an ultrasound examination or X-ray image of the finger joint can also contribute to the diagnosis. A joint puncture on the finger is relatively difficult to perform due to the low amount of synovial fluid and is therefore usually used in the diagnosis of a gout finger only if a bacterial joint infection as the cause of the inflammation must be excluded.

Other causes of inflammation of the finger joints

The symptoms of a gout finger are not always characteristic and can also indicate other illnesses. For example, the following other causes may be responsible for the discomfort of the finger:

  • Infection of the joint (septic arthritis)
  • acute inflammatory thrust in joint wear (activated arthrosis)
  • Rheumatism (rheumatoid arthritis)
  • reactive arthritis (joint inflammation after a bacterial infection - such as the gastrointestinal tract or the respiratory tract)
  • systemic lupus erythematosus
  • Pseudogout (deposits of calcium crystals)

Treat gouty fingers

An acute attack of gout on the finger is usually first treated with an anti-inflammatory analgesic such as diclofenac or ibuprofen. In contraindications to these agents, the physician may alternatively prescribe cortisone or a similar drug in tablet form. However, the active ingredient colchicine, which was previously often prescribed for gout on the finger, is rarely used today because of the severe side effects.

Since cold relieves inflammation, cold compresses as well as cryotherapy in a gout finger can make sense. Medicines from homeopathy can also be used in addition to the drug treatment.

On the other hand, surgery is only to be considered in the case of a chronic gout finger and only in exceptional cases.

Continuous therapy: Lower uric acid levels

After the first acute attack of gout, treatment with a uric acid-lowering drug is usually necessary to prevent the progression of gout. In most cases, the active substance allopurinol is used, which reduces the formation of uric acid in the body.

Alternatively, so-called uricosuric drugs such as Probencid can be used. They act via an increase in uric acid excretion via the kidney. However, these drugs are no cure for gout - a change in diet is therefore essential to avoid the recurrence of a gout finger.

Prevent gouty fingers

To prevent a gouty finger, you can do a lot by changing your lifestyle and your diet - this also applies if you have only been detected increased uric acid levels, without it came to a gout attack:

  • Low-purine diet: Since uric acid is produced during the breakdown of purines, you should make sure that you eat as few purine-rich foods as possible - here you will find more information on the subject of nutrition in gout.
  • Reduce alcohol consumption: Alcohol inhibits uric acid excretion and can trigger a gout attack. Beer also contains purines and should therefore be avoided if possible.
  • Drink enough: In order to support the excretion of uric acid via the kidney, you should drink at least 1.5 liters of liquid per day.
  • Avoid fasting: During longer periods of hunger, more uric acid accumulates. You should therefore abstain from fasting diets and crash diets.
  • Strive for normal weight: Obesity promotes an increase in uric acid levels and is therefore a risk factor for gout. However, be sure to reduce your weight slowly to avoid uric acid growth.

Mostly good prognosis

If a gout finger is diagnosed in time, the prognosis is usually very good. Early treatment can usually prevent permanent damage to the joints of the fingers and bones, as well as a chronic course.

If gouttophi have already formed, they often dissolve again under medical therapy. Surgery with a chronic gout finger is only necessary in exceptional cases - for example if the tophi causes a carpal tunnel syndrome or a tendon rupture.

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