Gouty tofus: photos, methods of treatment

When a purine metabolism is disturbed, a disease called gout develops in the body. It is characterized by the accumulation of salts of uric acid in bone tissues and leads to attacks of arthritis. In the chronic course of the pathology on the joints are formed a kind of nodules - gouty tofusi. They indicate a critical level of urate in the blood.

Medical certificate

Tofuses are gouty nodules consisting of uric acid crystals. They are limited to connective tissue. Tofusy appear with prolonged gout, usually after 6 years from the moment of the first attack of the disease. However, under the influence of adverse factors, gouty nodules appear after 2-3 years. It is a question of non-observance of a diet, infringement of excretory function of kidneys and reception of diuretic preparations.

These low-aesthetic formations worsen the appearance of a person and disrupt the full mobility of the joints. In the absence of treatment, they begin to expand, to destroy cartilaginous tissue. Often provoke the formation of ulcers and even necrosis of the skin.

The main causes of

Uric acid is a product of the disintegration of purines and is present in every organism. Normally in an adult, its content is 1000 mg. Purines are synthesized as a result of metabolic processes. They also enter the body together with food. Uric acid is present in the blood plasma in the form of urate sodium. Otherwise they are called "free" salts. With an increase in uric acid levels, hyperuricemia develops. Over time, it leads to gout.

The onset of the disease usually occurs asymptomatically. Many people do not even suspect of violations in the body. Clinical manifestations are revealed only after several years. All this time urate crystals accumulate in the tissues and joints, causing significant harm to the body. Gouty tofusi are a clear sign that the disease has passed from an acute stage to a chronic one.

Clinical picture

Tofuses are dense formations of rounded shape. Their size can vary from 2 mm to 8 cm. Most often located in the subcutaneous tissue near the joints. Surface localization of gouty nodes helps to diagnose them during physical examination. Tofusi protrude under the skin in the form of tubercles of yellowish color. Derma above them is usually rough and dry.

During the remission of education, they have a static position, do not show a tendency to increase in size. Progression of the disease and insufficient treatment contribute to the growth of gouty nodes, affecting the surrounding tissues. There may be an increase in the pain syndrome.

The active course of the pathological process leads to the opening of the gouty tofus and the formation of fistula. Of the latter, a yellowish secret appears. This complication is accompanied by an increase in temperature and severe pain in the affected area. Fistulous course sometimes self-tightening. However, most often its development becomes chronic with regular opening and subsequent scarring.

Area of ​​localization of

Urat deposits are most often observed in areas with poorly developed network of vessels. The temperature in these areas is lower compared to other parts of the body.

In most patients, tofus are localized in the following areas:

• fingers and toes;
• ears;
• stops;
• knees;
• area of ​​the elbow joint.

In especially severe cases, when the level of uric acid in the body exceeds all permissible standards, urates begin to accumulate in the internal organs. It's about the kidneys and bone tissue.

Possible complications of

Patients with a diagnosis of "gout" should understand how dangerous this disease is. Tofusy is a collection of urate salts. At high concentrations of uric acid in the seals, there comes a time when this component begins to flow back into the blood.

In the absence of treatment, gouty tofusi eventually spread to all new areas. They can cover not only the fingers of the limbs, but also the ears and elbows. Formations quickly destroy skeletal elements, significantly worsen the condition of the skin and joints. In neglected cases, when limb mobility is lost, the patient receives a disability group.

Treatment Methods

The appearance on the body of gouty tophus, whose photos are presented just above, indicates the active accumulation of sodium monoaurate in the body. Ignore these manifestations is not necessary, you should immediately seek help from a doctor. Inattention to the signs of gout can lead to complications.

Diagnostics of formations includes external examination, as well as conducting instrumental survey methods. The patient must necessarily pass blood and urine tests to determine the indicators of uric acid. In order to identify deep nodules, x-rays are prescribed. Gouty tophus can also be found on the photographs of MRI and with the help of ultrasound of the ligament apparatus, joints. Based on the results of the survey, a comprehensive treatment is selected. Usually it consists of the following activities:

1. Change of lifestyle( rejection of addictions, alcohol).
2. Compliance with a special diet that excludes the use of foods high in purines( fish, mushrooms, legumes).
3. Medication therapy.
4. Strengthening of immunity.
5. Physiotherapy, massage.
6. Operative intervention.

The main goal of such a complex treatment is to prevent the development of complications, the relief of symptoms.

Application of medicines

Drug therapy is considered a kind of foundation in the fight against gouty tophi. As a rule, treatment is started with the drug "Allopurinol" to reduce the uric acid in the body. Dosage and duration of reception is selected strictly individually.

As additional medication, uricosuric drugs are prescribed. They increase the excretion of uric acid from the blood. This group of funds is represented by Probenecid and Sulfinpyrazon.

The nature of the gout is changeable. In its development there are acute periods, when the pain syndrome is particularly pronounced, and the stages of remission. To stop the unpleasant symptoms involve non-steroidal anti-inflammatory drugs( "Orthofen", "Diclofenac").They are used in the form of injections and ointments.

Physiotherapy and massage

As in the case of other disorders of the support apparatus, the fight against gouty toffee is not complete without physiotherapy. It helps to normalize blood circulation in the affected area, relaxes muscle musculature. The use of specific procedures depends on the stage of the course of the pathology:

• in the acute phase involves impulse points and treatment with UV rays;
• at the stage of remission, it is advisable to use ultrasound and mud therapy.

In the absence of pain at home, you can do self-massage sessions. Procedures are recommended to begin with stroking the periphery of the joint and light rubbing, gradually moving to neighboring tissues. This approach contributes to the overall relaxation of the muscles. When gout massage should start from remote areas, consistently getting ready to the focus of pain. The duration of one procedure should not exceed 15 minutes.

Let's consider an example with a gouty tofus on the toe. In this case, the massage should proceed with the shin, gradually approaching the epicenter of pain. Soft impact on the affected joint stimulates blood circulation, which contributes to the excretion of urate sodium into the blood. Intensive movements are strictly prohibited. Also, do not hold sessions during the exacerbation of pathology.

Surgical intervention

When conservative treatment is not effective, surgical removal of the formation is recommended. In addition, the operation is resorted to in the following cases:

• urate deposits have reached an excessive scale;
• there is a strong deformation of the joint structure;
• nodules sprouted into nearby tissues.

The operation itself for gouty tofus consists of several stages. First, local anesthesia is administered. Then a small incision is made on the affected area. Through it a bag with pathological tissues is excised. This area is washed with antiseptic solutions and cosmetic seams are applied.

The next 7-10 days the patient is in hospital under supervision. Every day he is dressed. After 10 days, the sutures are removed, and the doctor examines the operated area. With a positive result and no complication, the patient is released home.

Traditional medicine help

How to remove gouty tophi on the fingers and toes using non-traditional drugs? Recipes of folk healers, as a rule, are aimed at improving metabolic processes in the body. Completely get rid of nodules is unlikely to succeed, but really to stop signs of inflammation of tissues. Below are the most effective methods of influencing the problem.

1. Decoction on the basis of leaves of dioecious nettle, flaxseeds and cowberries. To make it, you need to mix all the ingredients in equal proportions and pour boiling water, insist for 2 hours. Take a decoction of the half cup before eating.
2. Baths with Siberian larch branches. As an auxiliary ingredient, you can use straw oats. The procedure should be repeated 2-3 times a week, with the duration of one session should not exceed 20 minutes.

Large tofuys can be reduced using as a compress potato slurry or cabbage leaves. The iodine grid has an excellent therapeutic effect. It is recommended to apply it directly to the education itself.

Prevention of

In most cases, gouty tophi on the fingers and toes are the result of a prolonged course of the underlying disease, the presence of which a person may not even guess. The appearance of nodules indicates a serious pathological process in the body. Therefore, it is better to take care of preventive measures in advance. They are reduced to compliance with the following rules:

1. Regularly undergo preventive examinations, take tests. In this situation, it is possible to detect abnormalities in the concentration of uric acid in a timely manner and take the necessary measures to normalize it.
2. If the family has already diagnosed cases of gout, it is recommended that the course "Allopurinol" be drunk for preventive purposes. However, you first need to consult a doctor who will choose the dosage of the drug.
3. A special diet helps to reduce the risk of tofusi. It provides for the exclusion of foods rich in purines from the diet. This fatty fish, coffee, red meat and all kinds of legumes.
4. Compliance with the drinking regime plays an important role in the prevention of pathology. Clean water rinses all parts of the body and removes excess urate salts.

Gout does not lend itself to complete cure. However, adherence to the doctor's recommendations and elementary preventive measures allows for a long time to maintain the state of remission.