Gout: Difference between revisions

Revision as of 11:52, 31 January 2012

A joint disease caused by high levels of uric acid in the blood.

It is a disease of purine metabolism resulting in high uric acid levels. Uric acid is the final metabolite of this process.

When it is deposited in joints in high levels it forms crystals causing a localised inflammatory response.

There are a variety of risk factors@

Lifestyle - foods such as meat, alcohol, sweetened drinks (with fructose) and seafood. Coffee, vitamin C and physical fitness decrease risk.
Genetics - there appears to be some genetic variability in uric acid production. There are a whole bunch of hereditary disorders too (you don't need to know them - they're really rare.)
Medical - metabolic syndrome involves gout in 75% of cases. Renal failure, polycythaemia, haemolytic anaemia, psoriasis can all cause it. (Lead poisoning and organ transplants can too.)

The exam question will say:

SWOLLEN BIG TOE - you will think GOUT! It is involved in 50% of cases. However, any joint can be affected.

2-4 hour onset
begins at night (as body temperature is lower)
tophi - deposits of monosodium urate usually found on the elbow (another med school classic)
fatigue
high fever

@@ Line 16: / Line 16: @@
 ===Clinical Features===
-Can affect any joint but classically a swollen big toe.
+The exam question will say:
+'''SWOLLEN BIG TOE''' - you will think GOUT! It is involved in 50% of cases. However, '''any joint''' can be affected.
+*2-4 hour onset
+*begins at night (as body temperature is lower)
+*'''tophi''' - deposits of monosodium urate usually found on the elbow (another med school classic)
+*fatigue
+*high fever
 ===Investigations===