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Gout

Sangili Chandran, MD and Ahja D Steele, MD, Doctor of Medicine Reviewed 06/2022
 


BASICS

DESCRIPTION

  • An inflammatory arthriti leading to an acutely red, hot, swollen joint, which can progress to a chronic tophaceous joint that is associated with pain, nodule formation, and cutaneous...

DIAGNOSIS

HISTORY

Typical first presentation of gout (2): 
  • Intensely painful acute inflammatory arthritis, usually a gout flare, affecting a lower limb joint, which can be self-limited over a period of...

TREATMENT

GENERAL MEASURES

Supportive care including ice packs, rest, mobility assistance, and adequate nutrition and hydration 

MEDICATION

Acute treatment 
  • Pharmacologic treatment should be initiated wit...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Serum uric acid measurements q2–5wk while titrating urate-lowering treatment to goal

  • Regularly monitor CBC, renal function, liver function test, ...

REFERENCES

1
Abhishek A, Roddy E, Doherty M. Gout⁠—a guide for the general and acute physicians. Clin Med (Lond). 2017 Feb;17(1):54-59. 
2
Rogenmoser S, Arnold MH. Chronic gout: Barriers to effective man...

CODES

ICD10

  • M10.269 Drug-induced gout, unspecified knee

  • M10.161 Lead-induced gout, right knee

  • M10.221 Drug-induced gout, right elbow

  • M10.152 Lead-induced gout, left hip

  • M10.232 Drug-induced gout, left wris...

CLINICAL PEARLS

  • Acute gouty arthritis can affect ≥1 joint; the 1st metatarsophalangeal joint is most commonly involved at presentation (podagra).

  • Monosodium urate crystals found in synovial fluid aspir...

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