GOUT-INVESTIGATIONS

SUMMARY

1. Intracellular monosodium urate crystals = gout. These are yellow & termed negatively birefringent.

2. Evidence of uric acid deposition in the tissues (linear densities overlying cartilage visible on US; uric acid deposits visible on CT; and subcortical bone cysts visible on radiographs/MRI indicative of bony tophi).

3. The uric acid level does not correlate with an attack of acute gout, only confers risk.

4. As serum UA levels increase > 9-10 mg/dL, incidence of gouty attacks increases to 5% per year.

5. Older women may present with polyarticular pseudo-rheumatoid crystalline arthritis (gout or pseudogout that presents similarly to RA): look for crystals in the joint fluid.

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].