gout and pseudogout Flashcards
gout is most common in
young men or older men who drink too much
gout causes
- increased production of urate caused by high alcohol, red meat and seafood intake or haemolytic diseases
- reduced urate secretion caused by chronic kidney disease, hypothyroidism or drugs e.g. diuretics and chemotherapies
gout is a crystal artrhopathy associatied with deposition of…
needle shaped, negatively birefringent sodium urate crystals in joints due to build up of urate in blood
gout acute presentation
- mono-arthritis that suddenly develops in 1st MTP, ankle or knee joint
- sudden onset of pain in affected joint, with joint being hot, swollen and red
gout chronic presentation
- multiple acute attacks
- development of tophi at affected joint (large, painless, white deposits of sodium urate)
gout diagnosis
- bloods showing high urate and high CPR
- joint aspirate showing needle shaped, negatively birefringent crystals
- serum uric acid
- blood cultures to rule out septic arthritis
- during an acute attack urate can be normal
gout acute management
- NSAIDs
- colchicine
- steroids
- most acute attacks last for 2 weeks
- don’t give allopurinol in acute attacks as worsens gout
gout chronic management
- allopurinol
- febuxostat
- give if > 2 acute attacks or tophi develop
- chronic renal failure/renal stone = allopurinol
diuretics = allopurinol - azathioprine = don’t give allopurinol
- don’t stop allopurinol during acute attack if patient is already on it
pseudogout is most common in
older men
pseudogout causes
unknown but associated with metabolic disorders e.g. diabetes, hemochromatosis, hyperparathyroidism, aging and injury
gout is a crystal artrhopathy associatied with deposition of…
rhomboid shaped, weekly positive birefringent calcium pyrophosphate crystals in the joint
pseudogout diagnosis
joint aspirate showing rhomboid, weakly positive birefringent crystals
pseudogout management
- NSAIDs and possible intra-articular steroids
- colchicine
- steroids
