- Joint swollen & tender
- 1st Toe, Knee, Ankle, Wrist are most common
- Abrupt onset (within 24 hrs)
- duration ~1 week, resolves
- For undiagnosed patient, seek Hx of prior typical gouty flares
- Seek Tophi — urate deposits in pinna & bursa [see pix below]
- Beer & Liquor (not wine)
- Diuretics; maybe low-dose aspirin
- High uric acid common among general population
- May be normal in acute Gout
- Best time to order is >2 wks after acute attack has subsided
- “urate” or “negatively bifringent” crystals = Gout
- Joint Erosions (get X-Rays for chronic gout)
- Renal Stones
- Renal Failure (follow Creatinine; ? 24-hr urine for Uric Acid)
See also postings Monoarticular Arthritis and Polyarthralgias.
Tophi