Tophaceous Youth

[Keith Taylor (GoutPal Admin)]

I am 30 years old and recently had a tumor removed from my ankle.  I got the biopsy results last week and it turns out they are calling it a gout/tophus.  From what I read these develop around 10 yers after having gout which means I was around 20 when I started with gout.  Isnt that young for gout?  

Also, I have psoriasis and maybe the arthritis that comes with it – could this all be related – sounds like I am filled with arthritis – what the heck?

[zip2play]

Randy,

Twenty is a bit young but not impossible. It is also possible the tophus grew very fast.

The medical profession is fond of compartmentalizing arthritis. But I think there is more of a tie-in between, gouty arthritis, psoriatic arthritis, rheumatoid arthritis, osteoarthritis, and even “bad backs” than commonly thought

Controlling your serum uric acid to below 6 may eventually give you relief from your other pains and psoriasis. Getting rid of your urate is going to be a long process becasue where there is one noticeable tophus, there are likely many not so noticeable.

Are you taking any drugs for gout yet? What is your serum uric acid?

[Keith Taylor (GoutPal Admin)]

I can’t add much more to zip2plays response, except a small point about the psoriasis.

It is possible for small urate crystal deposits to form just under the outer skin. These are not as large and noticeable as the tophus you experienced, but they are enough to cause the skin to flake.

[Keith Taylor (GoutPal Admin)]

Thanks for the posts – I am new tothis – I just know that I have had a high uric acid level in the past and the tumor was a tophus.  The surgeon told me to follow up with my primary but I am thinking about going to the rheumatologist – he has been working with me on the psoriasis and pointed out the elevated uric acid level.  I am not on the meds for gout yet – but I guess that might be the next step.  I have had foot problems all my life – so glad to finally know what may be behind it – I was told by the foot doctor my feet are filled with arthritis and looks like the feet of a 60 year old – great to hear at 30.  You mentioned bck problems as well – I have a bi lateral pars defect on L5 – I just wish there was someone out there that could treat me by looking at everything.  By the way – I didnt start having the more serious health problems until i lost 115 pounds – i was healthier when i weighed 315 pounds – the irony!  O well – on to the next step – thanks again.

Randy

[Keith Taylor (GoutPal Admin)]

I think the rheumatologist is a good idea. It will take a few months of therapy to keep uric acid below 6mg/dL, and get rid of all the existing uric acid crystals.

If you are susceptible to gout, rapid weight loss can certainly add to the problem. However, it will be easier to cope now that you have lost the weight – just keep positive for a few months and make sure the rheumaologist gets your uric acid under control.

Please keep us informed with your progress.

[zip2play]

Randy, the best way to confirm gout is with a tophus biopsy…the diagnosis is 100% accurate.

Get to work with the allopuinol asap, in fact, WITH the tophi and misshapen feet, perhaps allopurinol PLUS probenecid is your best regimen. You can get good tophi diminishment with serum UA leves below 4.0.

Yes, a rheumatologist is a good idea, but perhaps ANOTHER rheumatologist because the one you have seems a little dense if he couldn't diagnose your gout before you needed surgical removal of a tophus and 60 year olfd feet. But a GP can order the drugs just as well and take blood draws just as well, but that requires YOU become the expert on gout and monitor your OWN treatment.

Perhaps just anecdotal, but I destroyed my back 33 years ago…broke off a process on L-5…disc between L5-S1 has collapsed, been destroyed and probably absorbed and the two vertabra have undergone something of an auto-fusion (Don't do DEADLIFTS!) The joints are a mess all the way up to L3. They recommended 3 joint fusion but I said no out of fear.  But the last 15 years on allopurinol have greatly eased the condition…so maybe you can look forward to some back relief also. <<Knocking wood furiously…I don't need GOD to strike me with an cute backache because of my hubris!>>

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