Gout and pseudogout: Difference between revisions
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==Pathophysiology== | ==Pathophysiology== | ||
*Primarily an illness of middle-aged and elderly adults | *Primarily an illness of middle-aged and elderly adults | ||
* | *Gout is most common form of inflammatory joint disease in men >40yr | ||
*Presence of crystals does not exclude septic arthritis | *Presence of crystals does not exclude septic arthritis | ||
*Precipitants | *Precipitants | ||
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*Joint pain may develop over period of hours | *Joint pain may develop over period of hours | ||
*Primarily involves first MTP, knee, ankle | *Primarily involves first MTP, knee, ankle | ||
==Diagnosis== | ==Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
#NSAIDs | #NSAIDs | ||
##Do not give to pts w/ renal insufficiency (use opioids instead) | ##Do not give to pts w/ renal insufficiency (use opioids instead) | ||
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==See Also== | ==See Also== | ||
*[[Joint Pain]] | |||
*[[Monoarticular Arthritis]] | *[[Monoarticular Arthritis]] | ||
==Source== | ==Source== | ||
Revision as of 20:50, 27 February 2012
Pathophysiology
- Primarily an illness of middle-aged and elderly adults
- Gout is most common form of inflammatory joint disease in men >40yr
- Presence of crystals does not exclude septic arthritis
- Precipitants
- Trauma
- Surgery
- Significant illness
- Change in medication
Clinical Features
- Joint pain may develop over period of hours
- Primarily involves first MTP, knee, ankle
Diagnosis
- Synovial fluid aspiration
- +crystals, no bacteria on Gram stain
- Serum uric acid levels are not helpful (30% of pts w/ gout attack have normal levels)
- ESR may be elevated
Treatment
- NSAIDs
- Do not give to pts w/ renal insufficiency (use opioids instead)
- Substantial pain relief should occur within 2hr
- Indomethacin 50mg po TID x3-5d
- Colchicine
- Can be used as alternative agent to NSAIDs in pt w/ normal renal/hepatic function
- 0.6mg/hr PO until efficacy or side effects occur (vomiting/diarrhea)
See Also
Source
- Tintinalli