DESCRIPTION
■ Acute onset with maximum pain in 4-12 hr
■ Recurrent pattern of similar attacks
■ Marked impairment of physical function
■ Resolution of symptoms within 3-14 days
■ May present as monoarthritis of any joint
DIAGNOSTIC TESTS
PT IMPLICATIONS
(click here to see references)
- Group of disease states caused by tissue deposition of monosodium urate due to prolonged hyperuricemia
- Hyperuricemia and gout develop from excessive uric acid production, a decrease in renal excretion of uric acid, or both
- Primary hyperuricemia results from an inborn error of metabolism and may be attributed to several biochemical defects
- Clinical manifestations of gout:
■ Acute arthritis
■ Soft tissue inflammation
■ Chronic tophus formation
■ Gouty nephropathy
■ Nephrolithiasis
- Rapid onset of pain
- Swelling and erythema of a distal joint and/pr periarticular soft tissue
- Key component of gout flares
■ Acute onset with maximum pain in 4-12 hr
■ Recurrent pattern of similar attacks
■ Marked impairment of physical function
■ Resolution of symptoms within 3-14 days
■ May present as monoarthritis of any joint
DIAGNOSTIC TESTS
- Uric acid lab tests
- Synovial aspirate lab tests
- CBC: mild leukocytosis often present
- Inflammatory markers: ESR and CRP often elevated
- Radiography for diagnosis and evaluation
- No typical findings in early gouty arthritis but late disease is associated with characteristic punched-out marginal erosions and overhanging edges
PT IMPLICATIONS
- Pain modulation using ESTIM and Ultrasound
- Lifestyle and dietary modification may be effective in highly motivated patients
- Pharmacologic treatment
- Stretching and increasing flexibility to reduce stiffness and increase circulation
- Endurance exercises to increase circulation
(click here to see references)