Gout and Gouty Arthritis: Causes, Management and Prevention – includes a free patient information PDF!

Download the free patient handout PDF near the end of this article!

This is a short presentation on gout and gouty arthritis. This also gives a brief idea about the causes of gout, its clinical features and investigations. This also provides basic information regarding management and prevention of gout and its associated complications.

Krishna Dr. A. Mohan Krishna, M.S. Ortho, MCh Orth(UK) is currently a consultant orthopedic surgeon at Apollo Hospitals, Jubilee Hills. He is part of the orthopedic team and he specializes in fracture management, arthroscopy, primary hip and knee arthroplasties, and paediatric orthopedics. He has presented papers in the orthopedic specialty.
Presentation used with permission from Dr. A. Mohan Krishna.

Presentation Transcript

  1. Dr. A.MOHAN KRISHNA M.S.ORTHO, MCh ORTH(U.K) Consultant Orthopaedic surgeon , Trauma, Arthroscopy, Arthroplasty Surgeon Apollo hospitals, Hyderabad Consultant Orthopedic Surgeon at www.drmohankrishna.com www.healthyjointclub.com www.bonesandjointsclinic.com
  2. This presentation is solely for educational purpose. The material included in the presentation represents educational material for the patients and not intended for any treatment purpose DISCLAIMER
  3. DESCRIPTION Gout is a metabolic disease in which crystals of Uric acid (Monosodium urate) gets deposited in joints , tendons and surrounding soft tissues.
  4. CAUSES The proteins that we consume in our diet get digested and undergo various steps of degradation in our body. Normal metabolism Purinies Diet /proteins Uric acid Rise in levels Formation of crystals Crystals collect in joint Rapid pain, swelling and redness of joint GOUT Elimination from the body:urine/faeces
  5. CAUSES High levels of Uric acid can be produced due to Intake of protein rich diet- high purine diet Abnormalities in chemical pathways that leads to excessive production of uric acid Certain drugs like Aspirin (Salicylates), Diuretics (Kidney drugs) interfere with the excretion of uric acid thereby raising its level in blood
  6. SYMPTOMS Uric acid deposits as crystals in joints and tendons Monosodium urate crystals Irritation, Inflammation of joints and tendon tissue Joints hot/red/swollen
  7. SYMPTOMS • Big toe of foot: classical location. • Hot/red and swollen • Ankles • Knee • Elbows • Joints of hand feet
  8. RISK FACTORS A protein rich diet./A high alcohol intake Certain races, like Maoris and Polynesian Obesity. Conditions that cause high cell turnover, such as polycythaemia (increased red cells), lymphomas and various other cancers can increase blood uric acid levels. Drugs like Diuretics (drugs increasing urine flow) or low dose salicylates, Kidney diseases.
  9. DIAGNOSIS: History Sudden onset of severe pain, swelling and redness of joint in great toe of the foot. swelling of joints of foot, ankles and hands History of alcohol or red meat intake a day prior to painful attack History of similar episodes in the past
  10. You can print copies of this PDF handout for your patients, to reinforce what you have told them.
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  11. DIAGNOSIS : Examination: Acute stages Long standing cases: uric acid crystals deposit in tendons and tissues – GOUT TOPHI
  12. INVESTIGATIONS Blood tests • Rise in uric acid Fluid examination from swelling • Uric acid crystals X-rays • Long standing cases joint destruction
  13. TREATMENT NSAID’S : Pain killers in high dose initially to settle pain and swelling Colchicine : can be given in acute attack Newer drugs to reduce level of uric acid in blood Rest to affected joint during acute phase Acute attack
  14. DRUG TREATMENT Given to control levels of uric acid in blood. To prevent long term complications. Drug dosage to be adjusted according to levels of uric acid. Allopurinol is one of the oldest and common drug used to control the levels of uric acid in blood. This drug inhibits xanthine oxidase which converts xanthine into uric acid. Probenicid and Sulphinpyrazone – Promotes excretion of uric acid through kidneys
  15. PREVENTION Once you are diagnosed with Gout, you’re a patient of gout for your life. Avoid Protein rich diet – High Purine foods Avoid Dehydration: especially in hot weathers Avoid unaccustomed strenuous exercise. Care should be taken in patients on long term diuretics and low dose aspirin.
  17. COMPLICATIONS OF UNTREATED GOUT joint damage (Arthritis), formation of gout tophi (swellings around the joint) and rare complication of chronic kidney disease
  19. CONTACT Dr.A.MOHAN KRISHNA M.S.Ortho., MCh Ortho(U.K)., Consultant Orthopaedic Surgeon, Apollo Hospitals, Hyderabad. Appointments: Secretary : 09247258989 09441184590 08332936085 www.drmohankrishna.com www.healthyjointclub.com www.bonesandjointsclinic.com Email: bonesandjointsclinic@gmail.com