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Gout

Introduction

Gout
Gout
Gout
Gout

Gout is a recurrent acute arthritis of peripheral joints which results from deposition, in and about the joints and tendons, of crystals of monosodium urate from supersaturated hyperuricaemic body fluids. The arthritis may become chronic.

Signs and symptoms

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Diagnostic Criteria

• The main clinical features are those of an acute gouty arthritis, often nocturnal, throbbing crushing or excruciating pain.
• The signs resemble an acute infection with swelling, hot red and very tender joints.
• The first metatarsophalangeal joint of the big toe is frequently involved

Investigation

• Serum uric acid level.

Treatment

  • Pharmacological

    • Ibuprofen 400mg (PO) start then 200mg 8 hourly until 24 hours after relief of pain.
    • Meloxicam 7.5mg–15mg (PO) 12 hourly for 5 days
    • Piroxicam 10–20mg (PO) once a day for 5 days
    • Institute anti-hyperuricaemic therapy e.g. Allopurinol give 100 mg daily. This may be increased up to even 600mg daily depending on response to reduce uric acid synthesis
    • Note: Aim is to maintain serum uric acid level below 8mg/dl (0.48mmol/l)

  • Non-pharmacological

    • In obese patient, reduce weight
    • Avoid precipitants e.g. alcohol
    • Prevention or reversal of deposition of uric acid crystals in males

Prevention

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Updated on,

6 Novemba 2020 08:19:18

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References

    1. STG
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