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Gout
See also in: Nail and Distal Digit
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Gout

See also in: Nail and Distal Digit
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Contributors: Abhijeet Waghray MD, Belinda Tan MD, PhD, Paritosh Prasad MD
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Synopsis

Gout is caused by body fluid urate saturation complicated by deposition of monosodium urate crystals in tissues. Elevated uric acid levels can be caused by overproduction of uric acid from purine catabolism or insufficient excretion by the kidneys and are necessary but not sufficient for the development of gout. The deposition of urate crystals in tissues leads to inflammation and subsequent tissue damage. The most common sites involved are the skin and joints. Gout can present as acute gouty arthritis or chronic tophaceous gout. Patients may also develop uric acid nephrolithiasis.

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.

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.

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References

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Last Reviewed: 07/09/2018
Last Updated: 07/09/2018
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Gout
See also in: Nail and Distal Digit
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Gout : Ankle pain, Foot pain, Hyperuricemia, Joint swelling, Joint tenderness, Smooth nodule, Toe pain
Clinical image of Gout
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