N.B.
1-Gout usually presents as recurrent attacks of acute inflammatory arthritis (a red, tender, hot, swollen joint).
2-The joint that is most commonly affected is the first metatarsalphalangeal joint at the base of the big toe (approximately 75 % of first attacks) and when this occurs it is known as " podagra ".
DD :
1- Septic arthritis >> only can be ruled out by joint aspiration and culture .
2- Chondrocalcinosis " deposition of calcium pyrophosphate " .
3- Gouty tophi, particularly when not located in a joint, can be mistaken for basal cell carcinoma or other malignancies .
Prevention :
1- Life style modification "dietary modification " ...
2- Allopurinol ...
3- Probenecid ...
4- EDTA , as a chelating agent, ..
Management of the acute attacks :
1- Conservative by : Ice application ..
2-NSAIDs
3- Steroid ...
4- Colchicine ..
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