Gout Flashcards
What is gout
Hyperuricaemia and deposition of urate crystals causing attacks of acute inflammatory arthritis
What are the risk factors for gout
Male Alcohol - esp. beer Red meat Seafood Diuretics Obesity
What sites are affected by gout
1st MTP - most common Knee Midtarsal joints Wrists Ankles Small hand joints Elbows
How do patients with gout present
Acute pain - peaks over 6-12 hours Inflammation Erythema Hot joint Fever and malaise *Itching and desquamation during resolution
What disease is gout associated with
Metabolic syndrome
How would you investigate gout
X-ray Synovial fluid aspiration
What would you expect to find on X-ray of a patient with gout
Punched out lesions Areas of sclerosis
What would you expect to find on synovial fluid aspiration of a patient with gout
Monosodium urate crystals Negatively birefringent needle-shaped crystals under polarised light
What medication would you use for acute gout
NSAIDs Colchicine
What medication would you use for recurrent gout
Allopurinol (2-3 weeks post-acute episode)
How does allopurinol work
It is a purine analogue and inhibits xanthine oxidase
This prevents uric acid production
What is this
Tophus
Nodular masses of monosodium urate crystals deposited in the soft tissues of the body
What are the complications of gout
Nephrolithiasis (kidney stones)
Tophi
Joint damage if untreated
*Uric acid kidney stones are not radio-opaque
