June 22nd, 2011
10:40 AM ET

Do I have gout or tendinitis?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Wednesdays, it's Dr. Otis Brawley, chief medical officer at the American Cancer Society.

Question asked by Chontelle of Houston, Texas:

I am 35, female and have elevated levels of uric acid. My doctor wants me tested for gout in my left ankle, but the pain in my ankle didn't start until I began using it to overcompensate for my other injured leg by limping. Will the black cherry concentrate I've heard about in pill form lower the uric acid levels, and how can I tell the difference between gout and tendinitis?

Expert answer:

Dear Chontelle,

Gout is a disease in which uric acid salts (urates) are deposited in joints or in soft tissues (this is called tophaceous gout). In joints, gout can cause attacks of extreme inflammation and pain.

The painful attack usually occurs in only one joint at a time and can be confused with extremely painful tendinitis, a very bad sprain, or a broken bone, even in someone with a history of diagnosed gout.

Gout is most commonly associated with pain in the joint of the big toe of middle-aged and older men who are obese, diabetic, hypertensive and drink alcohol, but gout can occur in any joint of adult men and women of any health status and any age. It is estimated that 3 to 5 million Americans have gout.

All patients with gout have a very high amount of uric acid in their blood. This is a condition called hyperuricemia. There are, however, patients with hyperuricemia who do not develop gout. Gout is most easily and commonly diagnosed by placing a needle into the inflamed joint and withdrawing fluid that is examined under a polarized light microscope. Crystals of uric acid salt are seen when the patient has gout.

A typical untreated gouty attack is very painful for two to three days and then starts getting better. The patient may have residual pain for two weeks. Medical suppression of an attack of gouty inflammation can decrease pain faster. It is best done with an oral drug called colchicine. Indomethacin or naproxen or other strong nonsteroidal anti-inflammatory drugs are also useful. In rare cases steroids can be injected into the joint to bring relief.

A number of things are known causes of a gout attack in people with hyperuricemia. These include splurging in a diet high in uric acid, such as meat and shellfish or especially organ meats such as sweetbreads and liver. Trauma or overuse of a joint can cause a gouty attack in someone with hyperuricemia, as can use of certain diuretics used to treat high blood pressure.

While gouty arthritis is diagnosed by aspiration of joint fluid, distinguishing tendinitis versus a sprain versus a fracture requires a clinical examination and possibly an X-ray or magnetic resonance imaging. The treatments differ dramatically. Tendinitis is treated with stretching; a sprain with elevation and rest; and a broken bone is casted to promote healing.

There are drugs, allopurinol and febuxostat, that can be taken daily for long periods of time to lower uric acid levels. These drugs lower risk of a gout attack while being taken, but they can worsen a gout attack if treatment is begun during the attack. A few patients will need to take other drugs to cause increased urinary excretion of uric acid. These are oral medicines and include probenecid and benzbromarone.

Some alternative medicine enthusiasts have promoted use of black cherry concentrate and other substances to lower risk of an attack, but there is little scientific evidence to show that they are effective.

soundoff (1,789 Responses)
  1. Sprinter Auto Repair


    June 5, 2021 at 08:18 | Report abuse | Reply
  2. free gay vidioes


    June 5, 2021 at 08:40 | Report abuse | Reply
  3. used appliances near me

    An impressive share! I've just forwarded this onto a coworker who was doing a little research on this. And he in fact bought me breakfast because I stumbled upon it for him... lol. So allow me to reword this.... Thanks for the meal!! But yeah, thanx for spending time to talk about this subject here on your site.


    June 5, 2021 at 09:06 | Report abuse | Reply
  4. Freightliner Sprinter Repair Near Me

    I blog often and I truly thank you for your information. This great article has really peaked my interest. I'm going to take a note of your website and keep checking for new details about once a week. I subscribed to your RSS feed too.


    June 5, 2021 at 09:17 | Report abuse | Reply
  5. Content Marketing Company


    June 5, 2021 at 09:27 | Report abuse | Reply
  6. camper repairs near me

    I like reading through an article that can make people think. Also, thank you for permitting me to comment!


    June 5, 2021 at 10:06 | Report abuse | Reply
  7. Mercedes Sprinter Van Repair Near Me


    June 5, 2021 at 11:08 | Report abuse | Reply
  8. geico painting commercial


    June 5, 2021 at 13:03 | Report abuse | Reply
  9. chloroquine malaria

    what is in hydroxychloroquine chloroquine hcl hco medical abbreviation

    June 5, 2021 at 21:43 | Report abuse | Reply
  10. Mercedes Benz Sprinter Repair 19444


    June 6, 2021 at 02:18 | Report abuse | Reply
  11. motorhomes for sale in orange county ca


    June 6, 2021 at 03:22 | Report abuse | Reply
  12. online casino malaysia

    Amazing issues here. I am very happy to look your article.
    Thanks so much and I'm looking ahead to touch you.
    Will you kindly drop me a mail?

    Feel free to surf to my page – online casino malaysia

    June 6, 2021 at 03:42 | Report abuse | Reply
  13. Mercedes Benz Sprinter Turbo Actuator Repair


    June 6, 2021 at 04:49 | Report abuse | Reply
  14. rv remodeling companies near me

    I wanted to thank you for this great read!! I absolutely enjoyed every bit of it. I've got you book marked to check out new stuff you postÖ


    June 6, 2021 at 05:57 | Report abuse | Reply
  15. ups drop off near me

    This is a very good tip especially to those new to the blogosphere. Simple but very precise infoÖ Thanks for sharing this one. A must read post!


    June 6, 2021 at 07:59 | Report abuse | Reply
  16. jeep dealer near me

    I'm more than happy to find this website. I want to to thank you for your time for this particularly fantastic read!! I definitely appreciated every little bit of it and I have you saved as a favorite to look at new information on your web site.


    June 6, 2021 at 11:13 | Report abuse | Reply
  17. Los Angeles Sprinter Repair

    You've made some decent points there. I looked on the internet for more info about the issue and found most people will go along with your views on this website.


    June 6, 2021 at 14:36 | Report abuse | Reply
  18. Sprinter Rv Repair Near Here

    This is a topic which is near to my heart... Best wishes! Where are your contact details though?


    June 6, 2021 at 18:32 | Report abuse | Reply
  19. singapore online casino slot

    Your style is unique in comparison to other folks I've read stuff from.
    Many thanks for posting when you have the opportunity, Guess
    I'll just bookmark this page.

    Here is my web-site; singapore online casino slot

    June 6, 2021 at 20:20 | Report abuse | Reply
  20. fiberglass repair near me

    Excellent blog you've got here.. Itís difficult to find good quality writing like yours nowadays. I seriously appreciate individuals like you! Take care!!


    June 7, 2021 at 09:54 | Report abuse | Reply
  21. rv solar near me


    June 7, 2021 at 12:59 | Report abuse | Reply
  22. rv leak detection

    I love it when people get together and share ideas. Great blog, keep it up!


    June 7, 2021 at 14:59 | Report abuse | Reply
  23. Authorized Mercedes Sprinter Service Centers Near Me

    Way cool! Some extremely valid points! I appreciate you writing this post and also the rest of the site is also really good.


    June 7, 2021 at 15:20 | Report abuse | Reply
  24. all class rv yorba linda


    June 7, 2021 at 16:39 | Report abuse | Reply
  25. https://mega888-my.com/xe88

    Howdy! This article couldn't be written much better! Looking at this post reminds me of my previous roommate!
    He continually kept talking about this. I'll send this information to him.
    Pretty sure he's going to have a very good read.
    Many thanks for sharing!

    Here is my site – apk xe88 – https://mega888-my.com/xe88,

    June 7, 2021 at 18:14 | Report abuse | Reply
  26. Sprinter Repair Mechanics

    Spot on with this write-up, I really feel this web site needs far more attention. Iíll probably be back again to read more, thanks for the advice!


    June 7, 2021 at 19:47 | Report abuse | Reply
  27. Megri Digitizing

    Wow!! well written article. I really like it and it gave me so much useful information. Keep up this kind of valuable posts with all of us 🙂

    Megri Digitizing

    June 8, 2021 at 00:55 | Report abuse | Reply
  28. Van Wheelchair Lift Repair

    I like reading an article that will make people think. Also, thank you for allowing me to comment!


    June 8, 2021 at 01:13 | Report abuse | Reply
  29. motorhome shops near me

    bookmarked!!, I love your web site!


    June 8, 2021 at 01:13 | Report abuse | Reply
  30. interior repair near me


    June 8, 2021 at 01:34 | Report abuse | Reply
  31. RV Fabrication Orange County


    June 8, 2021 at 01:38 | Report abuse | Reply
  32. tow truck repair


    June 8, 2021 at 02:19 | Report abuse | Reply
  33. truck painting near me


    June 8, 2021 at 02:44 | Report abuse | Reply
  34. RV Plumbing Orange County

    You ought to be a part of a contest for one of the greatest blogs on the web. I am going to recommend this website!


    June 8, 2021 at 02:51 | Report abuse | Reply
  35. box truck repair near me


    June 8, 2021 at 21:25 | Report abuse | Reply
  36. rv shades repair

    Aw, this was an extremely good post. Taking a few minutes and actual effort to produce a good articleÖ but what can I sayÖ I procrastinate a lot and never seem to get anything done.


    June 8, 2021 at 22:57 | Report abuse | Reply
  37. RV Mechanics Riverside

    This site really has all of the information I wanted concerning this subject and didnít know who to ask.


    June 8, 2021 at 23:09 | Report abuse | Reply
  38. box truck repair parts


    June 8, 2021 at 23:31 | Report abuse | Reply
  39. RV Camera Near Me

    Your style is really unique in comparison to other people I have read stuff from. Many thanks for posting when you've got the opportunity, Guess I'll just bookmark this web site.


    June 9, 2021 at 01:16 | Report abuse | Reply
  40. thvl1 trực tiếp hôm nay

    Coi Thẳng Bóng Đádemkhuya tvTheo thể thức thi đấu, đội thắng ở cặp đấu này sẽ giành tấm vé đến Lithuania trong ngày hội bóng đá lớn nhất thế giới cho futsal. Tuyển futsal Việt Nam bước vào trận play-off lượt đi tranh vé dự play-off World Cup 2021 với sự tự tin. Tuy vậy, HLV Phạm Minh Giang bày tỏ, toàn đội không ngán Lebanon tuy nhiên sẽ tìm cách để khắc chế sức mạnh của đối thủ bởi bên trên băng ghế huấn luyện là nhà cầm quân Ramiro Lopez, người từng dẫn dắt futsal Tây Ban Nha.|Dựa vào lịch tranh tài, bạn rất có thể sắp xếp làm việc


    June 9, 2021 at 01:49 | Report abuse | Reply
  41. RV Glass Repair Near Me


    June 9, 2021 at 02:37 | Report abuse | Reply
  42. rv slide repair


    June 9, 2021 at 03:32 | Report abuse | Reply
  43. pressure washing near me

    Commenting on a blog is an art. Good comments create relations. You’re doing great work. Keep it up. Flooring Installers of Pittsburgh, 1933 Crafton Blvd #5, Pittsburgh, PA 15205, (412) 415-7629


    June 9, 2021 at 03:56 | Report abuse | Reply
  44. pressure washing melbourne

    Interesting stuff to read. Keep it up. Flooring Installers of Pittsburgh, 1933 Crafton Blvd #5, Pittsburgh, PA 15205, (412) 415-7629


    June 9, 2021 at 04:42 | Report abuse | Reply
  45. SEO Marketing Experts


    June 9, 2021 at 08:54 | Report abuse | Reply
  46. Video Marketing Business


    June 9, 2021 at 10:25 | Report abuse | Reply
  47. Don Okoren

    Oh my goodness! Impressive article dude! Thanks, However I am having issues with your RSS. I donít understand the reason why I can't subscribe to it. Is there anyone else getting the same RSS issues? Anyone who knows the solution can you kindly respond? Thanx!!


    June 9, 2021 at 13:13 | Report abuse | Reply
  48. Phylicia Staniford


    June 9, 2021 at 13:53 | Report abuse | Reply
  49. Mavis Lapar

    Good post. I learn something new and challenging on sites I stumbleupon every day. It will always be interesting to read articles from other writers and use something from their web sites.


    June 9, 2021 at 14:29 | Report abuse | Reply
  50. Andria Dreka

    You are so interesting! I don't suppose I've read through a single thing like that before. So great to find someone with genuine thoughts on this topic. Really.. many thanks for starting this up. This website is something that's needed on the web, someone with some originality!


    June 9, 2021 at 14:29 | Report abuse | Reply
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Post a comment


CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.