Gout
See also in: Cellulitis DDx,Nail and Distal DigitAlerts and Notices
Synopsis
The acute form of gout presents as a painful, swollen, warm, and erythematous joint, usually monoarticular, with the most common joints affected being the first metatarsophalangeal joint, ankle, foot, and knee. The pain can be debilitating. Flares can last days to weeks if untreated and can become more severe and more frequent over time.
Chronic tophaceous gout presents most commonly involving the ear but can also affect other soft tissues, articular structures, bursas, or tendons. Smooth or multilobulated nodules can ulcerate, leading to extrusion of a chalk-like substance. Rarely, urate bullae may develop.
Men aged 40-50 are most commonly affected. Other risk factors include renal insufficiency, obesity, increased alcohol consumption, medications (eg, diuretics), lymphomas, leukemias, tumor lysis syndrome, and hemolysis as well as lead exposure (eg, from illegally distilled liquor, or "moonshine"; known colloquially as "saturnine gout").
Codes
ICD10CM:M10.9 – Gout, unspecified
SNOMEDCT:
90560007 – Gout
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Acute Gouty Arthritis: Chronic Tophaceous Gout:Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:07/08/2018
Last Updated:12/14/2022
Last Updated:12/14/2022
Gout
See also in: Cellulitis DDx,Nail and Distal Digit