THE CLINICAL FEATURES AND TREATMENT METHODOLOGIES OF GOUT

Sikander Ali, Manahil Ghazi, Syeda Manam Rubab Zahra

ABSTRACT

Gout is the most prevalent inflammatory arthritis and affects 2.5% of the general population in the UK. It is characterized by recurrent attacks of a red, tender, hot, and swollen joint. Pain typically comes on rapidly in less than twelve hours. The joint at the base of the big toe is affected in about half of cases. It may also result in tophi, kidney stones, or urate nephropathy. It is the only arthritis that has the potential to be cured with safe, inexpensive and well tolerated urate-lowering treatments, which reduce serum uric acid by either inhibiting xanthine oxidase – e.g. allopurinol or by increasing the renal excretion of uric acid. Of these, xanthine oxidase inhibitors are used first line and are effective in curing gout in the majority of patients. Gout can be diagnosed on clinical grounds in those with typical podagra. However, in those with involvement of other joints, joint aspiration is recommended to demonstrate monosodium urate crystals and exclude other causes of acute arthritis, such as septic arthritis. However, a clinical diagnosis of gout can be made if joint aspiration is not feasible. Gout was historically known as "the disease of kings" or "rich man's disease". It has been recognized at least since the time of the ancient Egyptians.

Keywords: Tophi, Urate nephropathy, Xanthine oxidase, Allopurinol, Septic arthritis, MRI, CT, DECT.