Gout

• crystalline depostion diseases
• abnormal purine metabolism=precipitation/deposition of monosodium urate crystals in synovial lined joints
• inciting factors: meds that increase serum uric acid, localized trauma, alcohol, purine-rich foods, postsurgical state
• male>female

Gout Xray

• characteristic radiolucent periarticular erosions, inoridinate soft-tissue enlargement
• Chronic=large deposits of gouty tophi, extensive articular and periarticular destruction

Gout Clinical Evaluation

sudden intense pain, redness, swelling, warmth, tenderness
Great toe MTP joint=50-75%
• usually clinical diagnosis based on PE & hx
• needle-shaped monosodium urate crystals which are strongly negatively birefringent under polarized light.
• serum uric acid may or may not be elevated

Gout Classification / Treatment

• indomethacin or colchicines
• chronic = arthrodesis or gouty tophi removal