GOUT

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GOUT

• A metabolic disease in which tissue deposition of
  crystals of monosodium urate occurs from
  supersaturated extracellular fluids and results
  in one or more clinical manifestations.
• These include
• 1 GOUTY ARTHRITIS
• Reccurent attacks of severe acute or chronic
  articular or periarticular inflammation
• 2 GOUT TOPHI
• accumulation of articular, osseous, soft tissue
  and cartilaginous crystalline deposits
• 3 GOUTY NEPHROPATHY
• renal impairment
• 4 URIC ACID CALCULI
• in the urinary tract

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Gout-uric acid

• Uric acid is the breakdown product of the purine
  residues of nucleid acid
• Two-thirds is excreted via the kidney and the
  rest via the gut

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Gout

• Primary gout
• Secondary gout
• -increase dietary intake of purines
• -overproduction e.g. Myelo- and
  lymphoproliferative disorders
• -decrease renal excretion in renal failure or
  tubular excretion

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ACUTE GOUTY ARTHRITIS

• An acute attack of gout is a dramatic, very
  painful condition
• typically ache and inflammation in one big toe
• The joint is
• swollen,
• red
• hot
• very painful
• The joint slowly returns to normal
• often with desquamation and peeling of the
  overlying skin

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ACUTE GOUTY ARTHRITIS-treatment

• NSAIDs are useful during acute attacks
• Colchicine
• Intra-articular steroids

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CHRONIC TOPHACEOUS GOUT

• Tophi-small chalky deposits appearing on the
• ears
• hands
• around MTP joints
• olecranon bursae
• If the condition is still not treated
• Gross knobbly swelling develop and may
• ulcerate
• become secondarily infected
• cause severe restriction of
• movement

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