6-2 Discussion Gout

Howdoesthediseaseaffectthemusculoskeletalandintegumentary

systemsinparticular?IchooseGout,afterrepeatedflare-ups,gout

canbecomesevereandpersistentandmayleadtojointdeformity.

Overtime,jointmotionbecomesprogressivelyrestrictedbydamage

causedbydepositsofuricacidcrystalsinthejointsandtendons.

(GoldmanL,2020)

Classification:Thenewclassificationcriteriaincludeclinical(pattern

ofjoint/bursainvolvement,characteristicsandtimecourseof

symptomaticepisodes),laboratory(serumurate,MSU-negative

synovialfluidaspirate),andimaging(double-contoursignon

ultrasoundorurateondual-energyCT,radiographicgout(Goldman

L,2020)

ClinicalManifestations:

Intensejointpain.Goutusuallyaffectsthebigtoe,butitcanoccurin

anyjoint,Lingeringdiscomfort.Afterthemostseverepainsubsides,

somejointdiscomfortmaylastfromafewdaystoafewweeks,

Inflammationandredness.,Limitedrangeofmotion(Goldman

L,2020)

Symptomsofgout

thejointfeelinghotandverytender,tothepointofbeing

unabletobearanythingtouchingit.

swellinginandaroundtheaffectedjoint.

red,shinyskinovertheaffectedjoint.

peeling,itchyandflakyskinastheswellinggoesdown.

DiagnosticTests:

Abloodtestcancheckthelevelofuricacidinyourblood.Ahigh

levelofuricacidcouldmeanyouhavegout.Whenyouhavegout,its

recommendedtocheckyoururicacidlevel,theyshouldstaybelow

6.0mg/dl.(GoldmanL,2020)

Jointfluidtest,it’saneedletodrawfluidfromyouraffectedjoint.

Uratecrystalsmaybevisiblewhenthefluidisexaminedundera

microscope.

X-rayimaging.JointX-rayscanbehelpfultoruleoutothercausesof

jointinflammation.

Ultrasound.Thistestusessoundwavestodetecturatecrystalsin

jointsorintophi.Dual-energycomputerizedtomography

(DECT).ThistestcombinesX-rayimagestakenfrommanydifferent

anglestovisualizeuratecrystalsinjoints.



GoldmanL,etal.,eds.Crystaldepositiondiseases.In:Goldman-Cecil

Medicine.26thed.Elsevier;2020.https://www.clinicalkey.com.

AccessedDec.23,2020.