Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment OptionsComplicationsSeeking Medical Care
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment Options
Complications
Seeking Medical Care
A gout flare affecting the joint and tendons of the heel can lead to pain and swelling, often mistaken asplantar fasciitis.
This article will focus on symptoms, diagnosis, and treatment options of gout affecting this very sensitive area.
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Symptoms of Gout in the Heel
The symptoms of a gout attack or flare-up affecting the heel typically come on suddenly and intensely and can include:
Often these symptoms can begin suddenly at night, leading to disrupted sleep. Chronic gout in the heel can also lead to limited range of motion and chronic pain.
What Causes Gout in the Heel?
Overproduction of urate can occur for a number of reasons, including:
Diagnosing Gout in the Heel
Since symptoms of gout can mimic other conditions such as plantar fasciitis, it is important to see a healthcare provider to receive an accurate and timely diagnosis. A rheumatologist specializes in inflammatory and joint diseases, such as arthritis and gout, and will be able to properly diagnose symptoms.
Gout can be definitively diagnosed during a flare-up, when a sample of fluid is removed from the swollen, affected joint and uric acid crystals are identified under microscopic evaluation. In addition to a thorough history and physical examination, blood testing and imaging studies can also aid in making the diagnosis of gout in the heel.
Blood Tests
A single blood test alone cannot diagnose gout, but it can be a helpful piece to the diagnostic puzzle. While some people with gout may have low to normal levels of uric acid, most will have a high level during a flare-up as defined as 6.8 milligrams per deciliter (mg/dL) or higher.
X-Ray
Ultrasound
Ultrasounds can help detect fluid in and around joint spaces, as well as inflammation within surrounding tendons, particularly the Achilles tendon of the ankle.
An ultrasound can also be used to guide the needle during a joint aspiration when trying to obtain fluid from the affected joint. This ensures the needle is inserted into the correct space for fluid removal.
Dual-Energy CT Scan
If joint aspiration is unsuccessful or fails to demonstrate urate crystals, dual energy CT scans may be considered.
Dual-energy CT scans have been found to accurately identify monosodium urate crystals in people with suspected gout, however, they may not be as accurate in people who very recently started experiencing symptoms.
Treatment Options for Gout in the Heel
Medications and dietary and lifestyle modifications can help control inflammation and uric acid levels and prevent future flare ups from occurring. Chronic inflammatory conditions that are better controlled have a lower likelihood of causing complications.
Medications
Given the severity of symptoms during an acute gout flare-up, medications can help quickly reduce and manage pain and swelling. Medications commonly used during a gout flare include:
Home Remedies and Lifestyle Changes
When it comes to managing chronic inflammatory types of arthritis, medication along with lifestyle changes provide the most long-term success in disease control. Some home remedies and lifestyle modifications that can help reduce disease activity include:
Can Gout in the Heel Cause Complications?
If left untreated, chronic gout can lead to numerous complications, including severe or permanent joint damage and destruction.If inflammation and an accumulation of uric acid are not treated, the joints can become damaged.
Another complication includes the visible accumulation of uric acid crystals in and around joints or under the skin, which is known astophi. Tophi, especially in the hands and feet, can cause difficulty in day-to-day activities, such as walking or fine motor movements.
When to Contact a Healthcare Provider
Most gout flare ups will resolve within a few days to a few weeks. However when it comes to inflammatory forms of arthritis, treating flare-ups quickly can help reduce the risk of developing permanent, long-term complications.
If you are experiencing pain, swelling, difficulty walking, or decreased range of motion of the ankle and heel, seek the advice of a qualified healthcare professional.
Summary
It is crucial to seek the advice of a healthcare professional to ensure proper diagnosis and treatment of gout of the heel. Through blood tests, imaging studies, and fluid analysis the correct diagnosis of gout can be made and there are numerous options for treatment of an acute flare as well as prevention of future flare-ups.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Rheumatology.Gout.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout.Ragab G, Elshahaly M, Bardin T.Gout: An old disease in new perspective – A review.J Adv Res. 2017;8(5):495-511. doi:10.1016/j.jare.2017.04.008Gaafar Ragab, Mohsen Elshahaly, Thomas Bardin.Gout: An old disease in new perspective – A review. Journal of Advanced Research. doi.org/10.1016/j.jare.2017.04.008.Centers for Disease Control and Prevention.Gout.American Kidney Fund.Tests for gout.Bongartz T, Glazebrook KN, Kavros SJ, et al.Dual-energy CT for the diagnosis of gout: An accuracy and diagnostic yield study.Annals of the Rheumatic DiseasesCollins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. doi: 10.1177/1759720X19847018.Chhana A, Dalbeth N.The gouty tophus: A review.Curr Rheumatol Rep. 2015;17(3):19. doi:10.1007/s11926-014-0492-x
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Rheumatology.Gout.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout.Ragab G, Elshahaly M, Bardin T.Gout: An old disease in new perspective – A review.J Adv Res. 2017;8(5):495-511. doi:10.1016/j.jare.2017.04.008Gaafar Ragab, Mohsen Elshahaly, Thomas Bardin.Gout: An old disease in new perspective – A review. Journal of Advanced Research. doi.org/10.1016/j.jare.2017.04.008.Centers for Disease Control and Prevention.Gout.American Kidney Fund.Tests for gout.Bongartz T, Glazebrook KN, Kavros SJ, et al.Dual-energy CT for the diagnosis of gout: An accuracy and diagnostic yield study.Annals of the Rheumatic DiseasesCollins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. doi: 10.1177/1759720X19847018.Chhana A, Dalbeth N.The gouty tophus: A review.Curr Rheumatol Rep. 2015;17(3):19. doi:10.1007/s11926-014-0492-x
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American College of Rheumatology.Gout.National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout.Ragab G, Elshahaly M, Bardin T.Gout: An old disease in new perspective – A review.J Adv Res. 2017;8(5):495-511. doi:10.1016/j.jare.2017.04.008Gaafar Ragab, Mohsen Elshahaly, Thomas Bardin.Gout: An old disease in new perspective – A review. Journal of Advanced Research. doi.org/10.1016/j.jare.2017.04.008.Centers for Disease Control and Prevention.Gout.American Kidney Fund.Tests for gout.Bongartz T, Glazebrook KN, Kavros SJ, et al.Dual-energy CT for the diagnosis of gout: An accuracy and diagnostic yield study.Annals of the Rheumatic DiseasesCollins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. doi: 10.1177/1759720X19847018.Chhana A, Dalbeth N.The gouty tophus: A review.Curr Rheumatol Rep. 2015;17(3):19. doi:10.1007/s11926-014-0492-x
American College of Rheumatology.Gout.
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Gout.
Ragab G, Elshahaly M, Bardin T.Gout: An old disease in new perspective – A review.J Adv Res. 2017;8(5):495-511. doi:10.1016/j.jare.2017.04.008
Gaafar Ragab, Mohsen Elshahaly, Thomas Bardin.Gout: An old disease in new perspective – A review. Journal of Advanced Research. doi.org/10.1016/j.jare.2017.04.008.
Centers for Disease Control and Prevention.Gout.
American Kidney Fund.Tests for gout.
Bongartz T, Glazebrook KN, Kavros SJ, et al.Dual-energy CT for the diagnosis of gout: An accuracy and diagnostic yield study.Annals of the Rheumatic Diseases
Collins MW, Saag KG, Singh JA.Is there a role for cherries in the management of gout?Ther Adv Musculoskelet Dis. doi: 10.1177/1759720X19847018.
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