Gout Flashcards
What is gout?
Arthritis due to deposition of crystals in the joint space
What crystals are deposited?
Monosodium Urate Crystals
What do the crystals cause? (2)
Acute inflammation and tissue damage
What is the main cause of Gout?
Hyperuricaemia due to impaired renal excretion of Urate
What are other causes of Gout? (2)
Over-production of Urate in the body or too much dietary intake e.g Red meat, seafood etc
Does it affect all joints?
It can do but it usually only affects one joint at a time
Which joint is usually affected?
More the 50% of cases occur in the Metatarsophalangeal Joint of the big toe
Is it common?
Relatively, it affects 1% of the population
Who is affected?
Normally affects males (4:1), and usually occurs between 30-60 years old. Asians are more at risk
Risk factors (9)
Male, meat, seafood, alcohol, diuretics, obesity, Hypertension, Cardiovascular Disease, raised triglycerides
Symptoms (9)
Acute joint pain, swelling, erythema, crescendo over 6-12 hours, fever, malaise, often has spontaneous resolution 5-15 days, itching, desquamation of overlying skin
Signs (1)
Nodules/Tophi around extensor surfaces
Differentials (3)
Septic Arthritis, Haemarthritis, Other Crystal Arthropathies
What is the gold standard investigation?
Joint aspiration to look for Bi-refringent Monosodium Urate crystals
Other investigations
Serum Urate levels (>4mmol/L), X-ray
