Ortho Oracle - orthopaedic operative atlas


– Discussion: (see GoutPal.com) – colchicine is used to treat acute gout; – mechanism of action involves inhibition of MSU-induced chemotactic factor release by PMNs; – in addition to treatment of acute gout, prophylactic administration of low doses of colchicine is effective in reducing the frequency of multiple attacks; – disadvantages: its onset of action … Read more

Diff DX: Gout

(see also: Hyperuricemia) Differential Rheumatoid Arthritis: Infection: w/ rapid destruction of gouty joint (by intraarticular infection), crystalline deposits may be released into synovial fluid, leading to confusion; note that indomethacin can quell the clinical symptoms of early septic arthritis (just as it will w/ gout), and therefore, NSAIDs should not be used to differentiate between … Read more

Pathophysiology of Gout

Discussion: humans lack the enzyme uricase which is involved in elimination of excess nucleic acid purines & nitrogenous waste products through production and excretion of allantoic acid; hence in humans, uric acid is end product of purines degradation; gouty arthritis begins w/ deposition of MSU crystals in synovial & periarticular tissue; factors related to microtophus … Read more