Gouty arthritis

what percentage of gout attacks occur on the big toe? what is this called?

75% Podagra

secondary gout

Blood dyscrasias, marrow disorders, renal disease

tophi or tophus irritate the synovium and lead to

pannus

what kind of bone erosions are in gout?

perarticular points AWAY from RA

gout joint pain will feel different than R.A in what way?

skin is dry in gout

gout onset and pain

sudden onset of pain prodromal irritability attacks precipitated by surgery, trauma, dietary or excess alcohol, starvation and drugs

Gout x ray showing overhanging edge sign

top arrow showing intraarticular erosions due to tophi overhanging edge sign at middle arrow above marginal erosion bottom arrow show periarticular erosions VERY indicative of gout over RA

20% of pt's with gout have ____ around joints or ear cartilage

tophi

primary and secondary gout look the same radiographically

TRUE

4 clinical presentations of gout

asymptomatic hyperuricemia acute gouty arthritis --1 MTP joint swollen, hot dry, rapid recovery polyarticular gouty arthritis --radiographic changes most frequently first encountered chronic tophaceous gout --avg duration 10-12 years

gout is a disorder of ___ metabolism leading to ____

gout is a disorder of purine metabolism leading to hyperuricemia

Podagra

Gout (MP joint of big toe)

are most gout attacks mono or poly articular?

MONO

spotty carpal sign

RA Or Gout? GOUT due to the amount of sclerosis RA generally is mostly erosive without much sclerosis

key radiographic signs in gouty arthritis

latent period 5-10 years asymmetrical joint narrowing LATE periarticular bone erosions overhanging edge sign soft tissue masses lack of juxta-articular osteoporosis - points away from RA

gouty arthritis clinical presentation gender age alcohol genetic

males 20:1 age 30-60 alcohol drinkers 50% 30% positive family history also post menopausal women on diuretics

primary gout is a

metabolic disorder leading to hyperuricemia

Tophus or tophi are made up of

monosodium urate crystals