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Morning all,
So last night I was looking at my right big toe joint and it is still larger than my left one as this is where I experienced my first acute attack. When I pull the skin tight around the joint it looks as if there is some “white stuff” underneath the skin…perhaps tophi. This joint was never larger than the left one until that dreaded 2 month period of attacks. My question is, can a significant amount of tophi be deposited in such a short period of time?
Yes,
They can pop up seemingly overnight and Yes, they are best seen as the cream colored body under the skin when the skin is pullled tight.
Unfortunately cartilege looks very similar so it's often hard to tell one from the other.
cjeezy said:
Yikes! Well hopefully AP therapy will eventually shrink it to some degree in the long term
cjeezy,
The first thing I did after reading your post is removed my shoe and socks and checked the joint. Well, I am happy to inform that there is no scope for pulling the skin tight as it is already full tight. When I just try my best by overdoing it, only thing I see is getting it pink in color like you pull skin from anywhere on the body.
The right joint where I had the attack now seems almost same size as the left joint( 90%). If the left joint did not get swollen, I guess the right joint has got to its almost normal position.
IMPORTANT THING TO NOTE HERE IS THAT I USED TO HAVE ABOUT HALF AN INCH LOOSE SKIN ROUND SPOT(like a penny coin) ON THE TOE BUNION JOINT WHERE I COULD ALWAYS FEEL SOME LIQUID KIND STUFF BENEATH THOUGH SKIN WAS RED /PURPLE IN COLOR. THE JOINT WAS ALSO SWOLLEN AND BIGGER THAN THE LEFT JOINT. THAT IS FEW MONTHS BACK BEFORE I STARTED ALLOP.
I HAVE SEEN GETTING IT BACK TO NORMAL AND SINCE LAST 4 WEEKS OR SO, THE 1/2 INCH PATCH HAS DISAPPEARED ALTOGETHER( I am poorer by a penny at-least) AND THE SKIN HAS BECOME VERY TIGHT ON THE JOINT WHILE THE SWELLING HAS ALL DISAPPEARED. THERE IS NO GLIMPSE OF THE LOOSE SKIN PATCH ANYMORE.
Zip,
Do you think I had some form of Tophi or crystals under the skin that have got dissolved mostly with Allop treatment? Or may be it was swelling due to toe injury which has since recovered?
By the way, I checked my SUA levels yesterday after almost 2 weeks…the values were 3.7, 3.2 and 3.7. I checked it 3 times to get the average.
I can probably assume my SUA levels below 4 most of the time.
That's great to hear Utube!
As far as pulling back on the skin, I don't have “loose skin” per se, but when I press around the area I can kinda see some white patches.
Also, I dropped back down to 300mg of AP about a week and a half ago (from 350mg). I tested last night and was also at 3.7!…although I do have pain still at times (mild).
Great to know that you are under 4 of SUA now….I am sure it will help resolve the things even faster.
I also do get pain at times but it is more due to foot positioning as my souter side on the small toe side is taking more load and that is causing some balancing issue and sending pain waves. The pain in the toe per se is not there unless I pull it a lot upward, probably take it beyond its limit. My current toe movement is back to normal( 90% plus normal).
I tried your test of pressing on the area. I do not see any white patches or feel anything unusual under the skin.
I think EVERY attack results in a tophus (or 20), an isolated area of monosodium urate that the body has walled off as an invader. Thing is, if they are tiny, or on the inside of a joint or under a fatty layer, they may not be visible, even to X-ray (or ESPECIALLY to X-ray.)
But when we have gout, we have tophi, and I am almost certain we will each take several of them to the grave.
Keith showed that fancy new scan (forget the name) that showed urate in a man's gouty foot and the deposits seemed to be EVERYWHERE.
No way except on autopsy will we ever know whether we have tophi in our shoulders, spines, knees, hips, etc.
God DAMN that uric acid…I hope it is good for something. (I once read that it is the singulary strongest antioxidant…I hope THAT'S good for something. I also read once that it is positively correllatable with IQ, and somewhat believable becasue only the higher primates have it…plus maybe the dalmation?????)
zip2play said:
Post edited 2:48 pm – September 26, 2010 by zip2play
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Keith showed that fancy new scan (forget the name) that showed urate in a man's gouty foot and the deposits seemed to be EVERYWHERE….
It's called SOMATOM Definition Flash which is a dual-source CT from Siemens (Germany), also known as DECT= Dual Energy Computed Tomography.
One thing puzzles me about the DECT scan for gout. If the software depends on using different frequencies to detect uric acid, why can't a normal scanner be set to that frequency, and show the urate deposits without the contrasting bone images?
From memory[somewhere in article]., I think the urate responds differently to different energies and a stereo view compares this live by differentiation between various deposit responses. Probably hidden in the patent?
I wish there was one near me- and if there was- that I could afford it!
Yes, but why can't you just set a normal scanner at 80 kiilovolts and see uric acid crystals, or the absence of them? More significantly, why can't this be applied to the decrease or increase in urate deposits as a result of treatment or lack of it? After all, I don't need a scanner to tell me I have bones.
I put it in the same bag as why urates don't show up in ultrasound scans.
This may not be accurate, as MRI is markedly different.
It does seem that in Gout,everything that can work against successful management goes against the sufferer in some way or other.
Maybe, with the incidence of gout increasing year by year and links with other curses like hypertension the medical establishment don't want the lid off a can of worms- as treatment at the level we know is needed would need a vast heave on the levers in the NHS anyway- and an associated cost burden. That's why I can't see accurate diagnosis getting a look in , apart from the equipment costs.
What if 50% of all gout today can be proven to be iatrogenic (doctor caused?) Since 1960's diuretics have been copiously prescribed to cure a symptomless, possibly harmess “disease”…hypertension. It is not unlikely that they were the cause of the gout epidemic we have today. Find that cause and effect and the cost to the medical profession will be BILLIONS in damages! So the answer is Don't Look!
A good analogy: I read that any MENTION of damages caused by the application of mercury by the ton into the mouths of children for a century is grounds for loss of license to practice dentistry.
Further back, Copernicus was told to STOP seeing that the planets revolved around the Sun.
There are facts that must NOT be proven without infuriating powers like the medical profession, the dental profession, or GOD in order of importance.
Ha Ha- Very good Zip! It's truly amazing what the human body can put up with -despite peoples' best intentions
zip2play said:
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There are facts that must NOT be proven without infuriating powers like the medical profession, the dental profession, or GOD in order of importance.
You mind if I slightly change a couple of words in your comment, Zip?
Medical industry, dental industry, GODly industry!
Whilst we are lining them up, please do not forget the uric-acid-raising-iron food industry
GoutPal said:
Whilst we are lining them up, please do not forget the uric-acid-raising-iron food industry
You are right, GoutPal. I only touched on Zip's remark, but since you mentioned about “lining them up”, let's not forget one of, if not, the most important money-making (literally) and wasting beyond human comprehension industry: the government of the United States of America and its brain child: the FDA which “protects” the industries from which the public at large wants and needs to be protected.
Keith (Gout Admin) said:
Yes, but why can't you just set a normal scanner at 80 kiilovolts and see uric acid crystals, or the absence of them? More significantly, why can't this be applied to the decrease or increase in urate deposits as a result of treatment or lack of it? After all, I don't need a scanner to tell me I have bones.
Keith,
?I found mention of the non-invasive diagnostic scanner, dual-energy computed tomograhy (DECT). [edit: link was to non-existing page]
It appears to be simply a matter of more sophisticated granularity facilitated by the dual nature of the embedded mechanism inside the housing, as Trev alluded to real time ?stereo? imaging. Monosodium urate still the tag being peeked at.
This topic is now closed.
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