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
