It’s hard to miss the new 40-foot-tall public health message that recently emerged near Pike Place Market. The project might raise some initial questions, but its intention is clear: Let’s talk about gout.
The green-and-white mural splashed onto the side of a building near First Avenue and Pike Street in Seattle’s downtown aims to raise awareness about a chronic type of arthritis that can cause pain and swelling in the joints — and reflects growing demand for gout education in the region, according to local providers.
The mural was installed earlier this month by Horizon Therapeutics, a biopharmaceutical company that focuses on medicines that address rare, autoimmune and severe inflammatory diseases. Part of the campaign’s goal is to communicate how misunderstood gout generally is and what technology is available to more efficiently diagnose the condition, said Gina Granat, a senior manager with the company.
“When you think of gout, you think of the flares, eating too much meat, drinking too much alcohol,” Granat said Friday. “We’re trying to help people understand that it’s so much more than that. … There could be a lot happening under the surface.”
Gout is a common type of inflammatory arthritis caused by a condition called hyperuricemia — when there’s too much uric acid in a person’s bloodstream, said Dr. Erin Bauer, a rheumatologist at Virginia Mason Medical Center and board co-chair of the Arthritis Foundation’s Great West Region. Once uric acid crystals build up in joints and tissues, they can cause pain, swelling and redness, often starting in the big toe, but can spread to ankles, knees and other joints.
“The idea behind the mural is that with changes in our imaging [technology], we can see that these gout crystals are in places we probably didn’t know before,” Bauer said. “Clearly, this is more of a systemic, full-body disease.”
In the U.S., about 4% to 5% of people are diagnosed with the condition, a number that’s been increasing over the past decade, Bauer said. As diagnoses rise, providers are working to be more aggressive in getting symptoms under control, she said.
The mural is inspired by a particular type of advanced imaging technology, known as dual-energy CT scanning, sometimes used to diagnose and treat gout. The green markings represent uric acid crystals that can develop around bones and joints — in this case, around the spine.
“We thought it would be a cool way to show that even if you don’t feel it, there could be uric acid beneath the surface deposited throughout your body, like around your spine, which not many people associated with gout,” Granat said.
Uncontrolled gout, typically meaning two or more flares a year or a specific level of uric acid, puts people at increased risk of a variety of kidney disease and cardiovascular impacts, like stroke or heart attack, Bauer said. Obesity and some high blood pressure medicines have been associated with gout diagnoses, but more recent research has suggested symptoms depend more on genetic disposition, she added.
“Some people are just genetically able to process those purines in our diet, which is a breakdown product of various foods, better than others,” Bauer said. “Their kidneys are just able to excrete more uric acid and get more out of the body, while some are holding onto more uric acid for unclear reasons.”
While there is no known cure, there are a number of effective treatments and medications that can help manage the disease, including ones that lower uric acid levels, break up gout crystals or help relieve painful flares.