GOUT-CLINICAL

SUMMARY

1. Acute gouty arthritis classically presents as tender and swollen joint that occurs at night and awakens the patient from sleep.

2. Pain reaches maximum intensity within the first 24 hours and self-resolves within a few days to several weeks.

3. In 50% of patients, the initial attack occurs in the great-toe MTPJ (termed "podagra").

4. The knee is the next most commonly affected joint.

5. In the early stages, the patient is completely asymptomatic between attacks (intercritical period) - a useful clue for diagnosis.

6. With chronic tophaceous gout, patients often have symptoms between flares.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].