Gout: Pedro’s Joint Damage
Written by: Marcos Otero, Retired Physician Associate
Pedro, a retired miner from Antofagasta, enjoys a traditional diet rich in red meats and seafood. He begins experiencing severe swelling and excruciating pain in his big toe after a family celebration. A local doctor diagnoses him with gout and advises dietary changes. However, Pedro finds it difficult to alter his eating habits due to cultural traditions and limited alternatives in his rural area. His gout flares become more frequent, leading to joint damage and mobility issues. A specialist referral is delayed due to a backlog at the regional hospital.
Patient Overview
– Age: 55
– Location: Antofagasta, Chile 🇨🇱
– Condition: Gout
Background
Pedro’s diet includes purine-rich traditional Chilean foods, and he leads a sedentary lifestyle due to long hours on the road.
Presentation of Symptoms
The pain began as mild discomfort but escalated into intense swelling and redness after a weekend family barbecue.
Key Symptoms
– Intense pain during flare-ups, especially at night.
– Difficulty walking.
– Redness and swelling in the big toe.
– Severe pain, especially at night.
Diagnosis & Treatment
– Diagnosis: Gout confirmed with clinical evaluation and elevated uric acid levels. Gout confirmed via uric acid levels.
– Treatment Plan:
– Anti-inflammatory medications prescribed for acute episodes.
– Long-term uric acid-lowering therapy suggested.
– Dietary counseling to reduce purine-rich foods.
Complications
– Permanent joint damage from untreated flare-ups.
– Reduced mobility affecting daily life.
Delays in seeking care result in joint damage and difficulty walking. Without treatment, his risk of chronic gout increases.
Cultural and Family Support
- Traditional Chilean meals, rich in purines, are central to Pedro’s family gatherings, making dietary changes emotionally challenging.
- His rural location limits access to specialists for advanced care.
- Pedro’s family prepares meals that support his dietary changes but find it challenging to modify long-standing traditions.
Today
- Good Outcome: Pedro manages his condition with medication and diet, regaining mobility and returning to work.
- Bad Outcome: Chronic flare-ups cause permanent joint damage, forcing early retirement.
