Gout Book.docx

CChhaapptteerr 66 :: (^)
AA wwoorrdd aabboouutt TToopphhii
Tophus or Tophi in plural is the same thing but what exactly is it? In Latin it is defined as
a stone. Ouch! You know this post won’t be pretty! Very simply, it is a deposit in the
elbow, toe, ankle, knee, ear, fingers or other joint in the body of monosodium urate
crystals in people who’ve had high uric acid levels of over 6-7mg/dl for a prolonged
period of time, a stage of gout’s development called chronic tophaceous gout. With
time a tophus will grow and go unnoticed but then it will grow and bunch up together
into bigger lumps of many tophi. Overall, 25% of gout suffers actually have tophi to
some extent. Hard to believe that there wasn’t an actual treatment for it until 1951 when
the drug phobenecid was first introduced. What did gout sufferers do before that?
Tophi should not be ignored when it first appears, although painless at the beginning, if
left untreated the condition will worsen as they cluster together and more uric acid
crystals form around the lump. What happens is our white blood cells attack the
invading uric acid crystals so what tophi really is then is a collection of crystals and dead
cells. This is not usually painful until they break out from the skin and appear as white or
yellowish chalky lumps. It can cause havoc to one’s health by destroying the joints,
cartilage and harming the organs (complications such as kidney stones) leading to
noticeable disabilities.
Without any treatment, tophi can appear on average at about 10 years after being first
diagnosed with gout but can develop earlier in older people although they can first
appear anywhere between 3 and 42 years! In addition, tophi can appear or pop up
suddenly overnight and sometimes the lump may actually grow so big that it must be
amputated in order for the joint to be free to move again. This can also cause the tophi
sufferer to end up getting an artificial joint. Furthermore, tophi usually appears in the
coldest parts of the body in areas furthest from the heart and where obviously blood
circulation is the poorest hence the appearance in the toes, ears, fingers and ankles.