7 Weeks of Pain & swelling, Can this still be gout?

[Dave Brown]

This started some 7 weeks ago, woke up with what I thought was a typical gout attack as I have had them before. After some 10 days of swelling & pain I decided to see my PCP. He didn’t suspect it was gout and ordered UA Level test along with an X-ray. UA Level was 8.5 and xray was negative. He said since the UA was at the upper limit but not over he still suspected a fracture. I was referred to a podiatrist who then ordered a bone scan. Bone scan was negative so they ordered an MRI and another UA Level. MRI was negative except for a little tendinitis. UA was again at 8.5… I then switched podiatrist for a second opinion. He has now suggested I see a Rheumatologists since the swelling and pain will not subside. Blood work was down for Rheumatoid Arthritis & it was negative as well. The only relief I can get is from a MEDROL dose pak which does take the swelling down but as soon as you finish the 5-day steroid the swelling returns. Can gout last this long? I’m really starting to doubt this gout… When my foot is swollen the pain is usually all on the left side of foot, sometimes in the ankle sometimes just behind the two little toes and always midfoot top outside edge. Can this be gout lasting this long continuous???

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How many weeks does Your Gout last?

[Keith Taylor]

Hi Dave,

Great first post, with more information than most non-member visitors provide. From your information, my gout calculator tells me you have at least an 81% risk of gout. If you have joint redness, hypertension, or cardiovascular disease, the risk will be higher.

Of course, this is a risk, not a diagnosis, but your PCP has completely misinterpreted your uric acid blood test results. A rheumatologist will take a joint fluid test, which has at least 81% chance of showing uric acid crystals – the absolute proof of gout.

Given such a high chance of gout, your choice is:
a) See a gout-competent rheumatologist now, and wait for results
Or
b) Proceed with uric acid lowering treatment now, and see if this reduces your symptoms to an acceptable level.

Tell me which way you want to go, and I’ll help you with the best specific next step. You can ask in the new gout forum. Or use the feedback form near the end of every GoutPal page.

In answer to your specific last question: “Can this be gout lasting this long continuous???”

Yes it can!

Gout never goes away until you either remove its cause, or control uric acid through medical means or lifestyle changes. 6 mg/dL is the absolute upper limit, so you need to question the quality of any healthcare provider who accepts levels higher than that. 5 mg/dL is the realistic upper limit for acceptable safety margin in otherwise healthy people. 2 to 3 is a good target for the first year of uric acid lowering treatment.

As you can see, nothing you say convinces me that gout is not your most obvious diagnosis. Your PCP is sadly misinformed about the upper limit, so his opinion about gout being unlikely is worthless. Are there any other reasons why it might not be gout?

If it is gout, as I said, it does not go away. Even on days that you do not experience pain, if uric acid is over 6.5 mg/dL, then dangerous crystals are forming. As they grow and spread, gout attacks become more frequent, more intense, and more widespread. Your description of your foot pain is not dissimilar to the pain I experienced many years ago. This then spread into my ankles, knees, elbows, shoulders, hands and wrists. I also had doctors who didn’t understand the upper limit for uric acid, so I know how to fight and win.

I’d like to help you get your gout under control before it spreads beyond your joints. Once it gets to your soft tissues, then all organs are at risk. Better to control it now, before heart disease and kidney disease develop.

[Ron Avery]

Hi Dave,

I can tell you 100% that gout can last that long. I had occasional attacks over the last 5 years lasting anywhere from 2 to 7 days. This past December I started feeling it in my ankle. It moved from ankle to other ankle to foot to knee to the other knee back to ankle etc. it lasted until the end of February until I finally decided thanks to GoutPal to take control of my gout. I started on Allopurinol and Colchicine and have been flareup free since then. My UA level was 503 which equates to 8.46. I just went for blood work today so we’ll see where I’m at after 1 month of 200mg daily of Allopurinol.

I know that I can have more flare ups as the UA crystals dissolve but at least I’m on the way to being gout free.

As Keith said, you need to get your UA level under control.

Good luck !

[Phil]

I agree with the above I have been I pain for about 6-7 weeks now and been on all types of medication, my diet is good and I have stopped drinking anything alcohol related weeks ago. I’m going to get on top of this somehow and get my level down to 6 so I can start the allopurinol, at the moment it is 9.1.I too have a doctor who doesn’t seem to understand gout.

[Keith Taylor]

@throbingtoe1 wrote: “I have stopped drinking anything alcohol related weeks ago”

Let me know when that wears off, Phil. A few pints around Liverpool is well overdue 🙂

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