Patient/caregiver was educated on the pathophysiology of gouty arthritis as follows:
Pain and tenderness
- Excess of uric acid in the blood can lead to crystallization of uric acid in multiple joints. Uric acid forms needle shaped crystals in the joints, resulting in inflammation and arthritis of the joints involved.
- White blood cells, which are protective and fight against any infecting organisms, increasingly migrate to the affected joint as part of inflammatory response. Chemicals released from these white blood cells not only increase sensitivity to pain, but also contribute to release of further pain causing chemicals.
- This results in exacerbated pain and tenderness in the involved joints. Pain with gouty arthritis can involve multiple joints simultaneously and happen in bouts, with multiple remissions and relapses.
Warmth and redness
- Chemicals from the white cells and damaged joint tissues can contribute to relaxation and dilation of blood vessels in and around the joint, resulting in more blood flow to the joint.
- Increased blood flow results in warmth and redness to the involved joint.
Swelling
- Chemicals released as part of inflammatory process contribute to relaxation and dilation of blood vessels in and around the joint, resulting in more blood flow to the joint.
- Dilation of blood vessels can also lead to increased leakage of fluid from the blood vessels. This increased leakage of fluid combined with fluid leaked out of damaged joint tissues lead to excessive swelling.
Limited range of motion
- The pain and swelling can lead to stiffness and limitation in the range of motion of the involved joints.
