MEDICAL INSIDER
DR. CORA LIM
FOR MAY 7, 2023
Applied Rheumatology Made Simple (A.R.M.S.)
(Part )
Our discussion now will focus on GOUTS. What is the spectrum
of gout? This includes Hyperuricemia, Acute gouty arthritis,
Tophaceous deposition of urate crystals, Urolithiasis, Interstitial
deposition of urate crystals in renal parenchyma, and Uric acid
nephropathy
What are the generalities of gouty arthritis? When we talk about
gouty arthritis, some generalities are: having extremely painful
episodes of arthritis; intermittent course, usually monoarticular
involving the big toe, ankle, knee; may later be oligo- or
polyarticular; there is tendency to abuse NSAIDs (and steroids);
and this could be precipitated by stress e.g. surgery blood
transfusion;
The following are some of the associated factors of gout: alcohol;
dyslipidemia; hypertension; urolithiasis; drugs e.g. pyrazinamide,
low dose ASA; renal disease; myeloproliferative disorder; and
strong family history.
How do we treat gout? These are some of the suggestions: Treat
acute attack with cold application, NSAIDs, colchicine,
(arthrocentesis); Do lifestyle modification; Treat concomitant
conditions; Remove precipitating factors e.g. drugs; Maintain
normouricemia; and Have prophylaxis to prevent acute attacks
In our next issue, we will discuss gout and the diet.