Acute onset of severe joint pain.
Swelling, effusion, warmth, erythema and/or tenderness of the involved joint(s).
Arthrocentesis with synovial fluid analysis shows strongly negative birefringent needle-shaped crystals under polarized light.
NSAIDs, colchicine, or corticosteroids are used to treat acute disease.
Allopurinol, febuxostat, or probenecid are used as uric acid-lowering drugs when long-term prevention of crystal deposition is indicated.
Complications include joint destruction, kidney disease, and urolithiasis.
Chronic tophaceous gout showing nodules in periarticular structures and arthritis
Adapted from BMJ Case Reports 2009 [doi:10.1136/bcr.03.2009.1668] Copyright © 2009 by the BMJ Group Ltd
- men aged between 40 and 60 years
- use of gout-inducing medication
- consumption of meat, seafood, or alcohol
- hx of medical condition with high cell turnover rate
- rapid-onset severe pain
- joint stiffness
- foot joint distribution
- few affected joints
- swelling and joint effusion
- family history of gout
- erythema and warmth
1st Tests To Order
- arthrocentesis with synovial fluid analysis
Other Tests to Consider
- uric acid level
- x-ray of affected joint
- nonsteroidal anti-inflammatory drug (NSAID)
recurrent gout: 2 to 3 weeks post acute episode
- intravenous pegloticase
- initiation or tapering of a urate-lowering agent
- prophylactic nonsteroidal anti-inflammatory drug (NSAID) or colchicine