Gout

Kwok et al offer information about gout which is a painful form of arthritis that can affect anyone. The prevalence of gout is about 4%, reflecting a 59% increase over the past decade. More than 60% of patients with gout also have a metabolic syndrome, so patients should be assessed with this in min...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2021-02, Vol.193 (5), p.E171-E171
Main Authors: Kwok, Timothy S H, Xu, Victoria Y Y, Lake, Shirley L
Format: Article
Language:English
Subjects:
Arthritis
Care and treatment
Diagnosis
Gout
Medical diagnosis
Nonsteroidal anti-inflammatory drugs
Practice
Rheumatism
Rheumatology
Risk factors
Steroids
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Summary:Kwok et al offer information about gout which is a painful form of arthritis that can affect anyone. The prevalence of gout is about 4%, reflecting a 59% increase over the past decade. More than 60% of patients with gout also have a metabolic syndrome, so patients should be assessed with this in mind. Risk factors for gout include male sex, increasing age, chronic kidney disease, dehydration, hyperuricemia from rapid cell turnover and excessive purine consumption. Flares often occur at night and usually target distal joints. Microscopy shows needle-shaped monosodium urate crystals with negative birefringence. Gout and septic arthritis can co-occur; therefore, it is important to rule out infection with Gram staining and cultures. Acute pharmacotherapy depends on patient comorbidities. Nonsteroidal antiinflammatory drugs, colchicine and corticosteroids are first-line therapies. Pre-existing urate-lowering therapy (ULTs) should be continued during flares.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.201392