Question

*Gout*

*1* Most commonly seen in *males over the age of 40*

*2* symptoms are caused by an *overproduction of uric acid*. Joints affected are extremely painful, red, hot, and swollen, usually monoarticular with the

*3* most common site at the *MTP of the big toe* (Podagra), or can affect multiple joints with no discernable distribution pattern; goes to the coldest areas first.

*4* On radiographs may see *overhanging margin, juxta-articular erosions after both joints are affected, and tophi crystals* may be visible. Bone destruction occurs before joint space decreases.

*5* Labs include increased *uric acid, +ESR*

*6* Special test is *joint aspiration*. Pharmacology/drugs when acute Colchicine, when chronic Allopurinol.

*7* Foods high in purines like red meat, red wine, beer, pork, and aged cheeses raise uric acid levels.

*8* Case management: dietary changes and pure cherry juice.

Answer 1

Gout is an arthritis form caused by uric acid crystal accumulation in the joints, with the big toe being the most common site for pain and inflammation. Diagnosis is assisted by lab tests and joint aspiration, while treatment includes the drugs Colchicine and Allopurinol, along with dietary modifications.

Step-by-step explanation:

Gout is a type of arthritis caused by the accumulation of uric acid crystals in the joints, leading to pain and inflammation. This condition is most commonly seen in males over the age of 40 and can severely impact the metatarsophalangeal (MTP) joint of the big toe, a symptom known as Podagra. Other symptoms include red, hot, and swollen joints, and in chronic cases, joint radiographs may show overhanging margins, juxta-articular erosions, and tophi crystals. Bone destruction in gout can occur before a noticeable decrease in joint space.

To diagnose gout, lab tests can reveal increased levels of uric acid and a positive erythrocyte sedimentation rate (ESR). A special diagnostic test for gout is joint aspiration, which involves extracting fluid from the affected joint to look for uric acid crystals. The pharmacological treatment for gout includes Colchicine for acute attacks and Allopurinol for chronic management. Dietary changes can also play a significant role in managing gout, with recommendations to avoid foods high in purines, such as red meat, red wine, beer, pork, and aged cheeses. Pure cherry juice is often recommended as part of the case management for gout.