GOUT A metabolic disease in which tissue deposition of crystals of monosodium

urate occurs from supersaturated extracellular fluids and results in one or more clinical manifestations.

These include:1: GOUTY ARTHRITIS Reccurent attacks of severe acute or chronic articular or periarticular

inflammation

2: GOUT TOPHI accumulation of articular, osseous, soft tissue and cartilaginous crystalline

deposits

3: GOUTY NEPHROPATHY renal impairment

4: URIC ACID CALCULI in the urinary tract

Gout-uric acid

• Uric acid is the breakdown product of the purine residues of nucleid acid

• Two-thirds is excreted via the kidney and the rest via the gut

Gout

• Primary gout• Secondary gout-increase dietary intake of purines-overproduction e.g. Myelo- and

lymphoproliferative disorders-decrease renal excretion in renal

failure or tubular excretion

ACUTE GOUTY ARTHRITISAn acute attack of gout is a dramatic, very painful

condition

typically ache and inflammation in one big toe

The joint is : swollen, red hot very painful

The joint slowly returns to normaloften with desquamation and peeling of the overlying skin

ACUTE GOUTY ARTHRITIS-treatment

• NSAIDs are useful during acute attacks

• Colchicine

• Intra-articular steroids

CHRONIC TOPHACEOUS GOUT

Tophi-small chalky deposits appearing on the:earshandsaround MTP joints olecranon bursae

If the condition is still not treated Gross knobbly swelling develop and may:

ulceratebecome secondarily infectedcause severe restriction of

movement