Gout with a cortisone injection for relief

Dr. Leo Krawetz explains gout and treatments for an acute gout attack. In this video Dr. Leo Krawetz gives the patient a cortisone injection for relief of the gout pain and swelling

Hi, I’m Dr. Leo Krawetz of Healthy Feet Podiatry.
The patient in front of me had a gout attack a couple of days ago.  A gout attack is when you get a buildup of uric acid in your blood.  It can come from foods that you take in.  The foods are high in purines and those are usually red meats, shellfish, and excessive amounts of alcohol.  Other things like asparagus and beans can also cause a gout attack.  In this patient’s case, he is an overproducer of purines and he tends to hit gout attacks about every three to six months.  He is on an anti-gout medicine, which is supposed to reduce the amount of uric acid that’s produced, but in some cases, it doesn’t and if you eat too many foods that are high in purines, you can still have a gout attack.  So, what I’m gonna do for this patient today is put a cortisone injection around the joint, which is gonna decrease the inflammation of the joint.  I’m gonna spray it with ethyl chloride and this freezes the skin before the shot, so it doesn’t hurt as much.  Now, I’m putting a mixture of Kenalog, which is a crystallized steroid and long acting, and dexamethasone phosphate, which is another steroid and is more shorter acting, and there is a couple local anesthetics and they are to numb the joint.  This will give him instant relief.  Usually, when the patient comes in with a gout attack, they’re in severe pain.  They’ll tell you that the sheets can’t touch the foot because it’s so painful and a lot of times, they’re on crutches because they can’t even put the foot on the ground.  This patient will have instant relief.  He’ll walk out of the office.  Within 48 hours, the redness and swelling will go down and of course, he’s gonna have to watch his diet and not consume anything that’s high in purines.  Thank you.