The third category of medications are those used during attacks of acute gout to decrease pain and inflammation. Both colchicine (Colcrys) and NSAIDs can be used during an acute gout attack to decrease inflammation and pain. Corticosteroids such as prednisone , methylprednisolone ( Medrol ), and prednisolone ( Orapred ), also can be used during an acute gouty flare. However, the total dose of steroids is generally limited due to potential side effects such as cataract formation and bone loss. Steroid medications are extremely helpful in treating gout flares in patients who are unable to take colchicine or NSAIDs.
X-rays are the standard imaging technique for gout (See Figures 12-17: Figure 12: Gout of the Base of the 1st Toe; Figure 13: Gout of the Distal Finger Joints; Figure 14: Gouty Change and Soft Tissue Calcification About the Base of the 1st Toe; Figure 15: Gouty Destruction at Multiple Finger Joints; Figure 16: Gouty Erosion at the Proximal Ulna at the Elbow; Figure 17: Large Tophus Seen as Soft Tissue Mass at the Elbow ) but in special cases, such as when gout needs to be separated from infection or tumor, Magnetic Resonance Imaging (MRI) ( Figure 18: MRI of the Knee Showing Gouty Soft Tissue Mass and Erosion of the Kneecap ) or ultrasound ( Figure 19: Power Doppler Study Showing Gouty Inflammation at the Base of the 1st Toe ) will be helpful.
Inhibition of xanthine oxidase by some Chinese
medicinal plants used to treat gout.
J Ethnopharmacol. 2000.
The enzyme xanthine oxidase catalyses the oxidation of hypoxanthine to xanthine and then to uric acid, which plays a crucial role in gout. A total of 122 traditional Chinese medicinal plants have been evaluated for the enzyme inhibitory activity. The most active was the methanol extract of the twig of Cinnamomum cassia, which was followed immediately by those of the flower of Chrysanthemum indicum and the leaves of Lycopus europaeus. Among the water extracts, the strongest inhibition of the enzyme was observed with that of the rhizome of Polygonum cuspidatum. The study demonstrated that the effects for these medicinal plants used for the gout treatment were based, at least in part, on the xanthine oxidase inhibitory action.