Gout is an inflammatory arthritis characterized by deposition of monosodium urate (MSU) crystals that accumulate in joints and soft tissues, resulting in acute and chronic arthritis,...
Classic presentation of acute gouty arthritis:
Intense pain and tenderness in the 1st metatarsophalangeal joint (podagra)
Can occur in the midtarsal, ankle, or knee joints
Joint may be s...
Acute treatment
General principles:
Acute gouty arthritis attacks should be treated with pharmacologic therapy (5)[C].
Pharma...
Serum uric acid measurements q2–5wk while ti...
M10.9 Gout, unspecified
M10.00 Idiopathic gout, unspecified site
M10.30 Gout due to renal impairment, unspecified site
M1A.30X0 Chronic gout due to renal impairment, unsp site, w/o tophus
M1A.9...
Monosodium urate crystals found in synovial fluid aspirate are pathognomonic for gout.
Pharmacologic treatment should begin within 24 hours of acute gout flare.
Asymptomatic hyperuricemi...
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Chronic tophaceous gout involving the hands and wrists.
Gout in Knee Labeled
Gouty (uric acid) tophi in a middle-aged woman with longstanding gout
<bold>FIG. 4.4.</bold> This "chalky" substance was aspirated from a patient's inflamed olecranon bursa, an appearance that is virtually diagnostic of tophaceous gout.
<bold>FIG. 4.4.</bold> This "chalky" substance was aspirated from a patient's inflamed olecranon bursa, an appearance that is ...
<bold>Fig B 10-17. Gout.</bold> Two examples of typical rat-bite erosions about the first metatarsophalangeal joint (arrows). The cystlike lesions have thin sclerotic margins and characteristic overhanging edges.
<bold>Fig B 10-17. Gout.</bold> Two examples of typical rat-bite erosions about the first metatarsophalangeal joint (arrows). ...
<bold>Fig B 10-18. Gout.</bold> Diffuse deposition of urate crystals in periarticular tissues of the hand produce multiple large, lumpy soft-tissue swellings representing gouty tophi. Note the erosive changes that typically involve the carpal bones and the distal interphalangeal and metacarpophalangeal joints of the fifth digits.
<bold>Fig B 10-18. Gout.</bold> Diffuse deposition of urate crystals in periarticular tissues of the hand produce multiple lar...
Figure 10-207 <bold>SKELETAL DISTRIBUTION OF GOUT.</bold>
Figure 10-210 <bold>GOUT: BONE EROSIONS. PA Foot.</bold> Observe the marginal erosion, demonstrating a classic overhanging margin sign (<italic>arrow</bold>), periarticular erosion (<italic>arrowhead</bold>), and intraosseous erosion (<italic>crossed arrow</bold>).
Figure 10-210 <bold>GOUT: BONE EROSIONS. PA Foot.</bold> Observe the marginal erosion, demonstrating a classic overhanging mar...