Clinical presentations of Gout (Hyperuricemia manifestations)

• It is chiefly a disorder of adult Male 5 % in Female . • Gout is uncommon before 3rd decade. • Peak of onset in Males (45 years) usually after 20 - 30 years of sustained hyperuricemia, and in post menopausal females above 60 years. There are 4 clinical presentations of Gout (Hyperurecemia)

• It is chiefly a disorder of adult Male 5 % in Female .
• Gout is uncommon before 3rd decade.
• Peak of onset in Males (45 years) usually after 20 - 30 years of sustained hyperuricemia, and in post menopausal females above 60 years.
There are 4 clinical presentations of Gout (Hyperurecemia) 

I. Asymptomatic hyperuricemia 

refers to elevation of serum uric acid prior to the development of arthritis.
 Probably 95% of hyperuricemic subjects never develop gout.

II. Acute gouty arthritis

• There is  painful arthritis.
• 90 % of cases of the initial attacks are monoarticular usually in the first metatarsophalangeal joint (podagra)
• Other initial sites:
- Ankles, wrist, heels, finger, knee, elbow.
It may be precipitated by:
- Trauma .- Surgery - Ingestion of alcohol- Exercise - Diuretics.
• Minority of patients showing acute gout with normal serum uric acid.
• Dramatic relief of pain with colchicine is suggestive.
• In severe attacks, overlying crystal cellulitis makes gout difficult to distinguish clinically from infective cellulitis .
• The typical attack is rapid onset reaching maximum severity 2-6 hours, often waking the patient in the early morning, it is self limiting over 5-14 days. Milder episodes for few days called peptite attacks.
• There is ++ temperature,++ TLC , l' ++ ESR.
• Intercritical periods are asymptomatic periods between attacks.
gout

III. Chronic tophaceous gout 

(chronic arthropathy, tophi, nephropathy)
a- Joints show :
• Polyarthritis.
• Asymmetrical joint affection.
• Exacerbation and remission.
• Late  : joint destruction.

b- Tophi
• Tophi are deposits of solid urate crystals that elicit a foreign body reaction of mononuclear cells with
granuloma formation, this occurs after longstanding severe hyperuricemia.
• Tophi deposits occur usually in the skin, around joints and ear lobule, extensor surface of fingers, achilles tendon or in elbows. Large deposition may cause overlying skin to ulcerate and extrude urate crystals.
• Periarticular deposition lead to a halo of radio-opacity on x-ray
C - Chronic gouty nephropathy (see below)
Gout-tophi

IV. Renal disease.

a- Uric acid nephropathy due to precipitation of uric acid in renal tubules. especially with myelo or Iympho proliferative diseases during chemotherapy (tumour lysis syndrome)(uric acid> 25 mg/dl) ===> Acute renal failure.
b- Chronic gouty nephropathy (chronic urate nephropathy)
Urate precipitation in renal interstitial tissue-s chronic renal
failure.
c- Uric acid stones
Uric acid precipitation in acidic urine ===> obstructive uropathy.

COMMENTS

BLOGGER
Name

andrology,2,Cardiology,10,Differential-diagnosis,5,E.N.T,31,General Surgery,4,General-Health,6,GIT,19,Gynecology,1,Hepatology,8,Internal-medicine,1,Microbiology,3,Orthopedics,1,Psychiatry,3,Respiratory-diseases,59,Rheumatology,50,STDs,3,Symptomatology,9,Urology,36,
ltr
item
Med2Date: Clinical presentations of Gout (Hyperuricemia manifestations)
Clinical presentations of Gout (Hyperuricemia manifestations)
• It is chiefly a disorder of adult Male 5 % in Female . • Gout is uncommon before 3rd decade. • Peak of onset in Males (45 years) usually after 20 - 30 years of sustained hyperuricemia, and in post menopausal females above 60 years. There are 4 clinical presentations of Gout (Hyperurecemia)
http://3.bp.blogspot.com/-j_QCdUKgFdI/UfEka_KS1WI/AAAAAAAAEc4/AfG07ETivFM/s400/gout.jpg
http://3.bp.blogspot.com/-j_QCdUKgFdI/UfEka_KS1WI/AAAAAAAAEc4/AfG07ETivFM/s72-c/gout.jpg
Med2Date
http://www.med2date.com/2013/07/gout-manifestations.html
http://www.med2date.com/
http://www.med2date.com/
http://www.med2date.com/2013/07/gout-manifestations.html
true
1129835733813637495
UTF-8
Loaded All Posts Not found any posts VIEW ALL Readmore Reply Cancel reply Delete By Home PAGES POSTS View All RECOMMENDED FOR YOU LABEL ARCHIVE SEARCH ALL POSTS Not found any post match with your request Back Home Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sun Mon Tue Wed Thu Fri Sat January February March April May June July August September October November December Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec just now 1 minute ago $$1$$ minutes ago 1 hour ago $$1$$ hours ago Yesterday $$1$$ days ago $$1$$ weeks ago more than 5 weeks ago Followers Follow THIS CONTENT IS PREMIUM Please share to unlock Copy All Code Select All Code All codes were copied to your clipboard Can not copy the codes / texts, please press [CTRL]+[C] (or CMD+C with Mac) to copy