Gout Flashcards
what is gout
a form of arthritis
caused by deposition of monosodium urate crystals in and around the joints
most commonly in the metatarsophalangeal joint (MTPJ)
really acutely painful
who gets gout
old men
higher prevalence in developed countries
what is the cause of gout
uric acid crystals get deposited in the joint
causes an acute inflammatory response
what are the risk factors for gout
obese, hypertension, diabetes
old
male
FH
certain medications e.g. thiazide diuretics
renal impairment so do GFR to investigate
how does gout present
excruciating, sudden burning pain in the affected joint
swelling, red, stiff, warmth in the affected joint
mild fever
tachycardia as a sympathetic response
usually presents in the metatarsophalangeal joint
how do you investigate gout
Arthrocentesis (joint aspiration) to analyse the synovial fluid
GFR as more common in renal impairment
how do you manage gout acutely and long term
Acutely:
- high dose NSAIDs- indomethacin
- colchicine as alternative to NSAIDs
- steroids (intra-articular injection)
long term control:
- ALLOPURINOL- decreases blood uric acid levels
what do you give people with recurrent acute attacks of gout (2 or more in a year)
allopurinol to lower urate levels in the blood
only when renal function allows
only start them on it when their acute attack has settled