In the world of medicine, every patient arrival is a challenge and an opportunity to learn. Once, the arrival of a patient gave me a deeper understanding of wrist pain. The patient, a man in his 50s, came to the clinic complaining of excruciating pain in his left wrist, which was swollen and a noticeable lump to the touch. Seeing his pained expression, I immediately made a preliminary judgment about a possible illness. The most common cause of wrist pain and swelling is nothing more than bone hyperplasia or gout, so I started a diagnosis for both possibilities. Through a detailed medical history and physical examination, I found that the patient usually eats irregularly, especially likes to eat high-purine foods, which makes me more inclined to believe that he may have gout. To further confirm the diagnosis, I arranged for him to have some necessary laboratory tests, which showed that his uric acid level was on the high side, which further strengthened my diagnosis of gout. After comprehensive consideration, I formulated a detailed treatment plan for him, including medication, diet and moderate exercise. During the treatment, I also emphasized the importance of prevention to him, hoping that he could pay attention to a healthy diet in his daily life and stay away from high-purine foods to reduce the possibility of gout recurrence.
Features of bone hyperplasia:
Osteohyperplasia is a common joint disease caused by articular cartilage degeneration, narrowing of the joint space, bone hyperplasia and osteophyte formation. The following are the characteristics of bone hyperplasia: It mostly occurs in the elderly: Bone hyperplasia mainly occurs in middle-aged and elderly people, and with age, the articular cartilage gradually wears out, causing bone hyperplasia reaction. Joint pain and stiffness: Patients often experience joint pain and stiffness, especially with activity or weight-bearing. This pain is generally more persistent and different from an acute attack of gout. Pain aggravated by activity: Patients with hyperostosis have worsening joint pain during activity, especially when carrying weights, affecting daily life and work.
X-rays showing osteophytes: X-rays are the main way to diagnose bone growths, which can see osteophytes and signs of bone growth at the edges of the joints. Common in weight-bearing joints: Bone hyperplasia is common in weight-bearing joints, such as the knees, hips, and lumbar spine. Not easy to cure: Hyperostosis is a chronic progressive disease that cannot be cured by specific drugs, and treatment is mainly by relieving pain, reducing symptoms, and delaying the progression of the disease. Pay attention to rest and exercise: For people with hyperostosis, proper rest and moderate exercise are very important to help relieve pain and maintain joint function. Although hyperostosis is not a life-threatening disease, it can have a significant impact on the quality of life of patients, and timely detection and effective treatment measures are essential to alleviate symptoms and delay the progression of the disease.
Features of gout:
Sudden onset of pain: The pain of gouty arthritis often occurs suddenly within a few hours, and the affected joint is sharply swollen, congested, and warm, and patients often describe the pain as if the joint has been burned or torn. Multiple joint involvement: In addition to the big toe joint, gout can also affect joints such as the knees, ankles, and wrists, causing pain, swelling, and dysfunction in the corresponding areas. Uric acid crystal deposition: Uric acid is deposited in the joints to form uric acid crystals, which activate the immune system, cause joint inflammation, and worsen pain and swelling. Onset and remission: Gouty arthritis is characterized by periodic episodes of onset and remission, during which pain is pronounced, and symptoms are reduced or disappeared during remission, but uric acid levels still need to be controlled for a long time. Susceptible to dietary influences: High-purine foods such as liver, kidneys, seafood, etc. can increase uric acid production, and alcohol can also interfere with uric acid excretion, so dietary control is especially important for patients with gout. Comorbidities: Gout is often accompanied by metabolic syndromes such as hypertension, hyperlipidemia, and diabetes, and should be considered comprehensively in treatment. Overall, gout is a painful and quality-of-life condition, and early diagnosis and treatment are essential to relieve pain and prevent complications.
Treatment
Hyperostosis: Medications: These include nonsteroidal anti-inflammatory drugs (such as ibuprofen) and pain-relieving drugs (such as paracetamol) to reduce pain and inflammation. Physical therapy: such as warm compresses, physiotherapy, etc., can relieve pain and promote joint function recovery. Surgical treatment: For severe cases of bone hyperplasia, surgical treatment, such as arthroscopic surgery or joint replacement, may be required. Gout: Medications: These include urate-lowering drugs (such as ibuprofen, methylprednisolone, etc.) and pain-relieving medications to control uric acid levels and relieve pain. Diet: Controlling your intake of high-purine foods and increasing your intake of fruits, vegetables and whole grains can help reduce uric acid production and gout attacks. Lifestyle management: Avoiding alcohol, reducing obesity, and maintaining a moderate amount of exercise can help prevent gout attacks. The above treatment methods should be carried out under the guidance of a doctor, and at the same time, pay attention to the differences in individual constitution and condition, and adjust the treatment plan.