Patients with gout are too familiar with the symptoms. Excruciating pain, swelling, redness. It’s easy to admit that something you have is a flash of gout. But what most patients cannot know is the damage that occurs when they are not hurt. This is called bone erosion, and it can slowly affect your mobility. Even if you don’t know it. What happens is that crystal deposits interact with bone and joint cells. And this leads to bone erosion. In this article, we consider degenerative processes or bone erosion in gout.

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Diagnosis of bone erosion

Fortunately, there are many technologies that can help to detect bone erosion. X-rays are the most basic tool that can identify bone erosion. But there are other modern devices, such as ultrasound, MRI and CT, which can accurately determine bone erosion. If you visit the clinic, you can be checked with an ultrasound. Because it is an easily accessible device that your radiologist can control.  

Gout Bone Erosion – Risks

There are few studies on the risk of bone erosion in patients with gout. The most recent of these was conducted by Dr. Mian Wu of the Sixth People’s Hospital at Shanghai University. Before starting the study, each participant had to answer the questionnaire. In which their age, gender, duration of the disease, concomitant diseases, medications, frequency of outbreaks and pain assessment were documented. The study involved 980 patients who then underwent an ultrasound scan to check for bone erosion. Out of 980, 431 or 44%, signs of bone erosion were detected. Out of 431, 338 had erosion in the first metatarsophalangeal joint. This is the joint that connects your toe.

In addition, they found that 62.4% of patients had detectable tophi. Those who had more than 2 tophi increased their risk by 15 times. The size of tophi did not affect the risk. Tophi is a developed form of gout in which deposits of uric acid crystals are so obvious that they form lumps on the skin. This is already so serious that in some cases an operation is required to remove them. 




In the course of the study, they also found that age was of great importance to risk. The older the patient, the higher the risk of bone erosion. The study shows that patients over 40 had a double risk of bone erosion. Those over 60 had an almost three times greater risk of an eroded joint.

Based on the data collected during the study, we can conclude that the risk of bone erosion associated with gout can be traced to four factors. And this: the duration of the state of gout, age, the number of tophi surrounding gout, and the presence of synovial hypertrophy. Those who had bone erosion with gout also had similar conditions. Including high blood pressure, high blood sugar, and kidney disease. If you have any of these conditions, you need to pay special attention to bone health.

Gout can also lead to bone spurs. This is due to the fact that inflammation on the joint can stimulate bone growth near it. This protrusion can reach 5 cm, causing pain and numbness in the area. What is scary is that most of these bone spurs are not diagnosed, so you can continue to build abnormal bone until it damages your nerves.

If your doctor finds a bone spur, you will have a simple operation to break it off. After that, you will be advised to take allopurinol so that the nerves can recover and the abnormal growth does not return. 

How to avoid bone erosion

Degenerative processes or bone erosion with gout can be avoided. The sooner a diagnosis is made, the better, because it allows you to take the right steps to prevent gout from worsening. Your doctor will recommend lowering your uric acid levels using a variety of strategies. These include drinking plenty of water, regular exercise, a low purine diet, and taking urate-lowering drugs.

Treatment for gout can be divided into two types: short-term and long-term. Short-term medications are used only during outbreaks of gout, while long-term medications are used continuously. This helps patients control uric acid levels so that they do not reach the point where the patient experiences another outbreak.

Speaking of outbreaks, you need to avoid as many outbreaks as possible. This is extremely inconvenient, and it is a sign that you have high uric acid levels. Not only that, but some medications used to treat outbreaks often lead to long-term risks to your bone health. Corticosteroids and colchicine are examples of drugs that can affect bones. Which leads to thinning of bones, infection and inability to produce blood cells.  

If you have a lifestyle, you may be tempted to stop taking your medication. But this can only increase the accumulation of uric acid. It is best to stick with long-term medications for gout. Since this is the only reliable way that your uric acids remain low. And you can prevent bone damage. It should not exceed 6.0 mg / dl. If so, consider changing your diet. Talk with your doctor and nutritionist if necessary. Because they can give you advice on how to lower uric acid levels.


Can bone erosion be reversed?

It is easy for young people to reverse bone erosion, as their body creates new bones faster. However, the older you get, the harder it will be to do it. Because the body creates fewer new bones and absorbs nutrients from old bones, which are no longer so good. However, if you maintain your health in old age, it may be easier to restore new bones. But this will happen much more slowly.

You need to feed your body with minerals that support bone health. The most obvious is calcium, which helps create new bones and keep them strong. Calcium supplements, be sure to supplement them with vitamin D to allow the body to absorb calcium. Not only are they good for your bones, they also help lower uric acid levels. 

Exercise is also another great way to deal with the unpleasant effects of bone erosion. Some exercises, such as strength training and muscle strengthening, help improve bone density. And also stimulate the production of new cells in the bones and slow down the loss of bone mass. You can choose from a variety of exercises that include brisk walking, jogging, dancing, weight lifting and pushups. In this article, we examined degenerative processes or bone erosion in gout.

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