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. RV Repair Shops Near My Location

    Itís difficult to find educated people in this particular subject, but you seem like you know what youíre talking about! Thanks


    June 16, 2021 at 03:57 | Report abuse | Reply
  2. RV Repair Shop

    The very next time I read a blog, I hope that it doesn't disappoint me as much as this particular one. I mean, Yes, it was my choice to read, however I genuinely thought you'd have something interesting to talk about. All I hear is a bunch of crying about something you can fix if you were not too busy looking for attention.


    June 16, 2021 at 05:39 | Report abuse | Reply
  3. RV Repair California

    Great article! We are linking to this great post on our site. Keep up the good writing.


    June 16, 2021 at 06:00 | Report abuse | Reply
  4. RV Repair Shop Near Me


    June 16, 2021 at 06:36 | Report abuse | Reply
  5. Sprinter Repair Shops Near Me


    June 16, 2021 at 07:22 | Report abuse | Reply
  6. RV Repair Garden Grove


    June 16, 2021 at 07:35 | Report abuse | Reply
  7. Camper Repairs Near Me


    June 16, 2021 at 11:34 | Report abuse | Reply
  8. RV Repair California


    June 16, 2021 at 11:57 | Report abuse | Reply
  9. dog groomers near me


    June 16, 2021 at 13:53 | Report abuse | Reply
  10. jewelry store near me

    Having read this I thought it was really informative. I appreciate you spending some time and energy to put this informative article together. I once again find myself spending a lot of time both reading and leaving comments. But so what, it was still worthwhile!


    June 16, 2021 at 14:02 | Report abuse | Reply
  11. car audio near me

    I enjoy reading an article that can make men and women think. Also, thanks for allowing for me to comment!


    June 16, 2021 at 14:50 | Report abuse | Reply
  12. best chinese food near me


    June 16, 2021 at 17:09 | Report abuse | Reply
  13. advance auto near me


    June 16, 2021 at 17:37 | Report abuse | Reply
  14. arcade near me


    June 16, 2021 at 19:33 | Report abuse | Reply
  15. burlington coat factory near me

    When I initially commented I appear to have clicked the -Notify me when new comments are added- checkbox and from now on whenever a comment is added I receive 4 emails with the same comment. Perhaps there is an easy method you are able to remove me from that service? Cheers!


    June 16, 2021 at 20:45 | Report abuse | Reply
  16. www.pharmaceptica.com

    hydroxycloquine https://www.pharmaceptica.com/

    June 16, 2021 at 21:59 | Report abuse | Reply
  17. instant covid testing near me

    Aw, this was a very nice post. Finding the time and actual effort to generate a superb articleÖ but what can I sayÖ I put things off a whole lot and never seem to get nearly anything done.


    June 16, 2021 at 22:00 | Report abuse | Reply
  18. RV Repair Shops Near My Location


    June 16, 2021 at 22:21 | Report abuse | Reply
  19. little caesars near me

    This is a topic that's close to my heart... Cheers! Where are your contact details though?


    June 16, 2021 at 22:28 | Report abuse | Reply
  20. Sprinter Repair Costa Mesa

    Hi! I could have sworn Iíve been to your blog before but after browsing through many of the articles I realized itís new to me. Regardless, Iím definitely happy I stumbled upon it and Iíll be bookmarking it and checking back often!


    June 16, 2021 at 23:08 | Report abuse | Reply
  21. RV Repair Shop Near Me

    I love it when folks get together and share views. Great blog, keep it up!


    June 17, 2021 at 01:28 | Report abuse | Reply
  22. RV Repair Orange County California


    June 17, 2021 at 01:54 | Report abuse | Reply
  23. bob evans near me

    This is a good tip especially to those fresh to the blogosphere. Brief but very accurate informationÖ Thank you for sharing this one. A must read post!


    June 17, 2021 at 04:13 | Report abuse | Reply
  24. RV Repair Shops Nearby


    June 17, 2021 at 05:01 | Report abuse | Reply
  25. trực tiếp k cộng

    Thẳng Soccer Ngày Hôm Nay, Link Xem đá Bóng Trực Tuyến 24hvtv3 hôm nayTheo 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 mang đến 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 vậy sẽ tìm cách để khắc chế sức mạnh của đối thủ bởi trên băng ghế huấn luyện là nhà cầm quân Ramiro Lopez, người từng dẫn dắt futsal Tây Ban Nha.|Dựa vào lịch thi đấu, quý khách có thể sắp xếp làm việc


    June 17, 2021 at 06:12 | Report abuse | Reply
  26. Camper Repair Shops Near Me


    June 17, 2021 at 06:12 | Report abuse | Reply
  27. Camper Repair Near Me

    This web site certainly has all of the information I wanted about this subject and didnít know who to ask.


    June 17, 2021 at 08:59 | Report abuse | Reply
  28. aquarium near me

    This is a topic that is close to my heart... Many thanks! Where are your contact details though?


    June 17, 2021 at 09:07 | Report abuse | Reply
  29. Camper Repair Places Near Me


    June 17, 2021 at 09:35 | Report abuse | Reply
  30. RV Repair Santa Ana


    June 17, 2021 at 11:56 | Report abuse | Reply
  31. printer near me

    You have made some decent points there. I checked on the net for more info about the issue and found most individuals will go along with your views on this site.


    June 17, 2021 at 13:08 | Report abuse | Reply
  32. flowers near me

    Your style is unique in comparison to other people I have read stuff from. Thank you for posting when you have the opportunity, Guess I will just book mark this blog.


    June 17, 2021 at 13:55 | Report abuse | Reply
  33. sam's club near me

    I couldnít resist commenting. Well written!


    June 17, 2021 at 15:10 | Report abuse | Reply
  34. lenscrafters near me

    Greetings! Very helpful advice within this article! It's the little changes that will make the largest changes. Thanks for sharing!


    June 17, 2021 at 15:16 | Report abuse | Reply
  35. escape rooms near me

    Itís difficult to find educated people on this subject, but you sound like you know what youíre talking about! Thanks


    June 17, 2021 at 15:57 | Report abuse | Reply
  36. tobacco store near me


    June 17, 2021 at 16:35 | Report abuse | Reply
  37. chase atm near me

    I'd like to thank you for the efforts you have put in writing this website. I am hoping to check out the same high-grade content from you later on as well. In fact, your creative writing abilities has encouraged me to get my own site now 😉


    June 17, 2021 at 18:18 | Report abuse | Reply
  38. eyeglasses near me

    Spot on with this write-up, I absolutely believe this amazing site needs a lot more attention. Iíll probably be returning to see more, thanks for the information!


    June 17, 2021 at 18:32 | Report abuse | Reply
  39. chiropractors near me

    Greetings! Very useful advice within this article! It is the little changes that will make the most significant changes. Thanks a lot for sharing!


    June 17, 2021 at 19:18 | Report abuse | Reply
  40. bars near me

    I was very happy to discover this website. I want to to thank you for your time due to this wonderful read!! I definitely liked every bit of it and i also have you saved as a favorite to look at new stuff in your website.


    June 17, 2021 at 19:37 | Report abuse | Reply
  41. home depot near me

    This is the perfect site for anyone who wishes to understand this topic. You know a whole lot its almost hard to argue with you (not that I actually would want toÖHaHa). You certainly put a new spin on a topic that's been discussed for ages. Wonderful stuff, just wonderful!


    June 17, 2021 at 19:51 | Report abuse | Reply
  42. ramen near me


    June 17, 2021 at 20:14 | Report abuse | Reply
  43. barnes and noble near me


    June 17, 2021 at 20:48 | Report abuse | Reply
  44. rv rental near me


    June 18, 2021 at 00:56 | Report abuse | Reply
  45. lunch near me


    June 18, 2021 at 03:18 | Report abuse | Reply
  46. ralphs near me

    You've made some really good points there. I checked on the internet for more information about the issue and found most individuals will go along with your views on this website.


    June 18, 2021 at 04:01 | Report abuse | Reply
  47. pawn shops near me


    June 18, 2021 at 04:08 | Report abuse | Reply
  48. private schools near me


    June 18, 2021 at 05:52 | Report abuse | Reply
  49. dog groomers near me

    Way cool! Some extremely valid points! I appreciate you writing this article and also the rest of the website is also very good.


    June 18, 2021 at 07:58 | Report abuse | Reply
  50. dentists near me

    Hi there, I think your website could possibly be having internet browser compatibility problems. Whenever I look at your website in Safari, it looks fine however, if opening in I.E., it has some overlapping issues. I just wanted to provide you with a quick heads up! Besides that, fantastic site!


    June 18, 2021 at 08:41 | 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.