Monday, 2 June 2008

Gout




asymetrical swelling affecting the small joints of the hand (and feet),the joints are severely deformed.there are tophi formation in the halex of the ear.

its a metabolic disorder of purine metabolism,characterized by hyperuricaemia due to either overproduction or under excretion of uric acid.

main risk factors:
age
diabetes
high BMI (obesity)
high protein diet
high alcohol consuption
hypertension
hyperlipidaemia
family Hx
drug Hx

what the main clinical manifestations?
what is the defferential diagnosis?
how would you investigate this patient?
what are the lines of management?

2 comments:

  1. investigations:
    1-synovial fluid examination reveals long needle-shaped crystals which are negatively birefringent under polarized light

    2-uric acid (may be normal in acute gout)

    ReplyDelete
  2. treatment:
    acute attack:
    NSAID's
    intra articulr steroids
    colchicine

    long term therapy:
    allopuranol
    probebcid

    ReplyDelete