Crystal Arthritis

Posted by e-Medical PPT Friday, April 22, 2011
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis.The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected.However, it may also present as tophi, kidney stones, or urate nephropathy.It is caused by elevated levels of uric acid in the blood which crystallize and are deposited in joints, tendons, and surrounding tissues.
Hyperuricemia is the underlying cause of gout. This can occur for a number of reasons, including diet, genetic predisposition, or underexcretion of urate, the salts of uric acid.Renal underexcretion of uric acid is the primary cause of hyperuricemia in about 90% of cases, while overproduction is the cause in less than 10%.
Dietary causes account for about 12% of gout,and include a strong association with the consumption of alcohol, fructose-sweetened drinks, meat, and seafood.
Gout may be diagnosed and treated without further investigations in someone with hyperuricemia and the classic podagra.A definitive diagnosis of gout is based upon the identification of monosodium urate (MSU) crystals in synovial fluid or a tophus.X-rays, while useful for identifying chronic gout, have little utility in acute attacks.
Options for acute treatment include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and steroids,while options for prevention include allopurinol, probenecid and febuxostat. Lowering uric acid levels can cure the disease.

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