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?
investigations:
ReplyDelete1-synovial fluid examination reveals long needle-shaped crystals which are negatively birefringent under polarized light
2-uric acid (may be normal in acute gout)
treatment:
ReplyDeleteacute attack:
NSAID's
intra articulr steroids
colchicine
long term therapy:
allopuranol
probebcid
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ReplyDelete