Rheumatology - Gout Flashcards
What is gout?
Crystal arthropathy due to high uric acid levels
Urate crystals deposited in the joint causing inflammation
What are gout tophi?
Subcutaneous uric acid deposits on the hands, elbows and ears
What are the risk factors for gout?
Male
Family history
Obesity
Alcohol
High purine diet
What are the most commonly affected joints?
Base of the big toe
Base of the thumb
Wrist
Can also affect knee and ankle
How is gout diagnosed?
Raised serum urate level
Exclude septic arthritis
Aspirated joint fluid
What does aspirated joint fluid show with gout?
Needle-shaped
Monosodium urate crystals
Negatively birefringent of polarised light
What does X-ray of a joint affected by gout show?
Maintained joint space
Lytic lesions
Punched out erosions
Erosions have sclerotic borders and overhanging edges
How are acute flares of gout treated?
NSAIDs
Colchicine- second line
Prednisolone- third line
What is used for gout prophylaxis and how do they work?
Allopurinol
Febuxostat
Xanthine oxidase inhibitors, lowers uric acid levels
