Gout
- Is a heterogeneous group of conditions related to a genetic defect of purine
metabolism that results in hyperuricemia.
- Occur as a result of uversecretion of uric acid or a renal defect to excrete uric acid, or
a combination of both.
- Primary hyperuricemia may be caused by severe dieting or starvation, excessive
intake of foods that are high in purines (shellfish, organ meats), or heredity.
- Secondary hyperuricemia is due to conditions
Pathophysiology
- With hyperuricemia, accumulations of sodium urate crystals, called tophi, are
deposited in peripheral areas of the body, such as the great toe, the hands, and the ear.
- Renal urate lithiasis (kidney stones), with chronic renal disease secondary to urate
deposition, may develop.
Clinical Manifestations
- Acute gouty arthritis (recurrent attacks of severe articular and periarticular
inflammation), tophi (crystalline deposits accumulating in articular tissue, osseous
tissue, soft tissue, and cartilage)
- The metatarsophalangeal joint of the big toe is the most commonly affected joint
(90%). The ankle or knee may also be affected. Less commonly, the wrists, fingers, and
elbows.
- Severe pain, redness, swelling, & warmth of the affected joint
Medical Management
- Pharmacology
- Diet