Attention, people with gout! The key to preventing tophi is to do these 8 things

1. What are tophi?

Gout is a chronic granuloma-like reaction caused by long-term high uric acid and the deposition of monosodium urate crystals in the surrounding tissues. The saturation of serum uric acid is about 420umol/L. When this concentration is exceeded, uric acid will precipitate in the form of crystals.

When the urate solution is oversaturated, urate crystals may precipitate. If no uric acid-lowering treatment is given subsequently, the crystals may continue to grow and enlarge.

Urate crystals can accumulate in parts of the body such as around joints, tendons, and skin connective tissue, forming yellowish-white raised growths of varying sizes, which are called tophi.

On the topic of tophi, experts from the Department of Traumatology and Orthopedics at Hunan Provincial Hospital of Traditional Chinese Medicine provide everyone with a scientific explanation and preventive measures.

2. Clinical manifestations of tophi

Gout stones vary in size, from small ones like rice grains to large ones like eggs. They appear as yellowish-white growths protruding from the surface of the skin, with thin skin on the surface. After rupturing, white powder or paste can be discharged.

There is generally no obvious pain, but if the tophi compress the surrounding nerves, tendons or bones, it may cause symptoms such as pain, numbness, and limited movement.

Tophi in the joints may also affect joint movement and cause joint deformity. They feel hard and nodular when touched. As the disease progresses, if the blood uric acid level continues to rise, tophi may gradually increase in size and number, and may fuse into pieces.

3. The harm of tophi

1. Gout stones can damage joints and bone structures. They can deposit and grow around joints, causing erosion of joint cartilage and bone, joint deformity, dysfunction, and even joint disability in severe cases, affecting normal mobility.

2. Gout stones can cause inflammation and pain. Due to the stimulation of urate crystals, the surrounding tissues will have an inflammatory reaction, causing patients to often feel pain, especially during activities or pressure, the pain may be aggravated, seriously affecting the quality of life.

3. Tophi may affect skin health. When tophi protrude under the skin, it may cause the skin to thin, break, and form ulcers, which are prone to infection and make wound healing difficult.

4. Long-term tophi may also affect kidney function. Urate crystals deposit in the kidneys, which may cause kidney stones, renal interstitial inflammation, etc., and further damage kidney function.

4. How to prevent tophi?

1. Control blood uric acid levels: This is the key to preventing the formation of tophi. Take uric acid-lowering drugs regularly as prescribed by your doctor, and monitor blood uric acid regularly to keep it within the target range (usually recommended to be below 360 μmol/L, and for patients with tophi, it is recommended to be below 300 μmol/L).

2. Dietary adjustment: Reduce the intake of high-purine foods, such as animal offal, seafood, broth, etc.; limit alcohol consumption, especially beer; reduce the intake of high-fructose beverages.

3. Increase water intake: Ensure adequate daily water intake, it is recommended to drink more than 2000ml (except in special circumstances) to promote uric acid excretion.

4. Control your weight: Obesity or being overweight will increase the risk of gout. Keep your weight within a normal range through a reasonable diet and moderate exercise.

5. Moderate exercise: Choose a form of exercise that suits you, such as jogging, swimming, Tai Chi, etc., but avoid strenuous exercise or sudden cold.

6. Regular work and rest schedule: Avoid staying up late and ensure adequate sleep to help maintain the body's normal metabolic function.

7. Regular physical examinations: monitor blood uric acid, kidney function and other indicators to detect abnormalities early and intervene in time.

8. Actively treat related diseases: such as hypertension, diabetes, hyperlipidemia, etc. These diseases may affect uric acid metabolism and increase the risk of tophi formation.

Orthopedic experts suggest: For the treatment of tophi, routine excision is generally not recommended, because the skin structure and nutritional status of tophi are different from those of normal skin, the local blood circulation is poor, the cell regeneration ability is weak, and postoperative infection is prone to occur, and wound healing is difficult. If effective uric acid-lowering measures are not taken after surgery, tophi may still grow again.

Hunan Medical Chat Special Author: Li Yuanwei, Hunan Provincial Hospital of Traditional Chinese Medicine

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(Edited by ZS)