Which department should I go to if my uric acid level is high?

High uric acid is a very common phenomenon in daily life. Many people have high uric acid. Generally speaking, high uric acid is a precursor to diarrhea. Many people with high uric acid go to the hospital for treatment but don’t know what to go to. In fact, high uric acid is generally treated in the rheumatology and immunology department. Patients with high uric acid must pay attention to their diet, drink plenty of water, and eat more fresh vegetables and fruits.

Which department is better for hyperuricemia?

Hyperuricemia is a prelude to gout and is also the pathological basis of gout. Hyperuricemia itself has no symptoms. Only when the affected area experiences redness, swelling, heat and pain can it be called gout. Therefore, patients with hyperuricemia should go to the gout department. In addition, patients who have the conditions are recommended to go to a gout specialist hospital for better treatment conditions.

Therefore, people with hyperuricemia are generally referred to the rheumatology and immunology department.

Among patients with hyperuricemia, 10% to 15% will develop gout. High uric acid can not only cause joint pain, but also damage kidney function, increase the risk of myocardial infarction, etc. With the increasing incidence rate year by year, hyperuricemia has become the fourth high after the "three highs" of hypertension, hyperlipidemia and diabetes.

Judging from outpatient conditions, the incidence of hyperuricemia has been increasing year by year and is gradually becoming younger. It is nothing new that many patients who come to the hospital for gout are young people in their twenties. Although there is no accurate assessment, the younger age of patients with hyperuricemia has become a consensus among clinical experts.

The high incidence age of hyperuricemia is 30 to 50 years old, and these people have more social engagements, which also effectively confirms that eating habits are an important reason. Nowadays, people are under great pressure in work and life, and they exercise less and less. Obesity and "three highs" may become some of the causes of hyperuricemia.

Hyperuricemia Test

Serum urate measurement

Different detection methods have different results. The normal value of uricase method for men abroad is generally 7mg/dl, which is about 1mg/dl lower for women than for men. Gout patients all have elevated blood urate levels, but due to the volatility of uric acid itself (such as increased secretion of adrenal cortical hormones and enhanced uric acid effect during acute attacks), as well as the influence of factors such as water diuresis and medication, blood urate levels may sometimes appear normal. Repeated examinations are necessary to avoid missed diagnosis.

Urine uric acid measurement

It is not very helpful for diagnosing acute arthritis because more than half of gout patients have normal uric acid excretion in urine. However, understanding uric acid excretion through urine examination is helpful for selecting drugs and distinguishing whether urinary stones are caused by increased uric acid. With a normal diet, uric acid excretion in 24 hours is less than 600 mg.

Synovial fluid examination

In the acute phase, when larger joints such as the ankles and knees are swollen, synovial fluid can be extracted for examination under a polarimetric microscope. Birefringent needle-shaped sodium urate crystals can be seen in the white blood cells, which is of diagnostic significance. The positive rate of optical microscopy is only half of that of polarimetric microscopy. Synovial fluid analysis is also helpful. The white blood cell count is generally between 1000 and 7000, and can reach 50,000, mainly segmented granulocytes.

X-ray examination

In the early stage of acute arthritis, except for soft tissue swelling, the joints are normal. Bone changes occur only after repeated attacks. First, the articular cartilage margins are destroyed, the joint surfaces are irregular, and the joint space is narrowed. As the lesion progresses, tophi are deposited in the subchondral bone and bone marrow. The bone presents a perforated defect with no rate of defect size. The edges are sharp and the defect is semicircular or continuous arc-shaped. The bone margins may have a hyperplastic reaction.

Special examination for tophi

Gout nodules can be biopsied, identified by special chemical tests (Murexide), and can also be measured by ultraviolet spectrophotometry and uricase decomposition.