Chiragra

Chiragra is a form of gout which affects the joints of the hands, and results in acute, painful episodes (attacks) of inflammation. The inflammation is caused by too much uric acid which forms small crystals in and around the joints. Uric acid is increased in the body by eating certain foods (especially seafood, red meat or organ meats such as liver or kidneys), as well as by drinking alcohol. The main symptoms of chiragra are swelling, tenderness and redness of the hand joints. Gout tends to affect people over 30 years old and men more commonly than women.

Gout is the underlying cause of chiragra and is caused by excess amounts of uric acid in the blood, which forms crystals in the joints. These crystals are very irritating, and cause the joint to become inflamed (red, swollen and painful). Gout is a very common condition. It tends to affect more men than women, and becomes increasingly more common with age. Drinking alcohol, eating red meat or organ meats (such as liver or kidneys) and using certain medications (such as heart failure and high blood pressure medications) increases the chances of having gout.

Typical symptoms include a severe pain in the hand and finger joints associated with redness, swelling, difficulty moving the joints and sometimes tophi (uric acid crystals deposits appearing as yellowish firm nodules). Symptoms often come on suddenly, and attacks of gout are often recurrent.

Diagnosis is based on the individual's medical history and physical examination. A doctor may take a sample of fluid from a swollen joint to look for evidence of gout crystals in the joint. Blood tests can monitor the amount of uric acid in the blood. Ultrasounds or X-rays of the joint may be helpful to look for signs of damage as a result of gout.

Pain and swelling during an attack of chiragra is managed with anti-inflammatory and pain-relieving medications (such as ibuprofen, paracetamol or colchicine). Lifestyle changes, such as losing weight, a healthy diet and taking regular exercise, might also be helpful in the management of gout.

Preventing future attacks of gout can be done by changing the diet to avoid foods which trigger attacks of gout and (if needed) with a medication called allopurinol. Allopurinol reduces the amount of uric acid in the blood. Losing weight might also be helpful preventing future attacks of gout.

• Gout of the hand