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| __NOTOC__ | | __NOTOC__ |
| {{Infobox_Disease |
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| Name = Gout |
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| Image = upper_tophaceous_gout.jpg |
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| Caption = Tophaceous Gout <br> (Image courtesy of Charlie Goldberg, M.D.)|
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| DiseasesDB = 29031 |
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| ICD10 = {{ICD10|M|10||m|05}} |
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| ICD9 = {{ICD9|274.0}} {{ICD9|274.1}} {{ICD9|274.8}} {{ICD9|274.9}} |
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| ICDO = |
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| OMIM = 138900 |
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| OMIM_mult = {{OMIM2|300323}} |
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| MedlinePlus = |
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| MeshID = D006073 |
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| }}
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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
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| {{Gout}} | | {{Gout}} |
| {{CMG}} '''Associate Editor-In-Chief:''' {{CZ}} | | {{CMG}} {{AE}} {{Shivam Singla}} |
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| == [[Gout overview|Overview]] ==
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| == [[Gout historical perspective|Historical Perspective]] ==
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| == [[Gout pathophysiology|Pathophysiology]]==
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| == [[Gout causes|Causes]]==
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| == [[Gout differential diagnosis|Differentiating Gout from other Diseases]] ==
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| == [[Gout epidemiology and demographics|Epidemiology and Demographics]] ==
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| == [[Gout risk factors|Risk Factors]] ==
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| == [[Gout screening|Screening]] ==
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| == [[Gout natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==
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| ==Diagnosis==
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| [[Gout history and symptoms|History and Symptoms]] | [[Gout physical examination|Physical Examination]] | [[Gout laboratory findings|Laboratory Findings]] | [[Gout x ray|X-ray]] | [[Gout MRI|MRI]]
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| ==Treatment==
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| [[Gout medical therapy|Medical Therapy]] | [[Gout surgery|Surgery]] | [[Gout secondary prevention|Secondary Prevention]]
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| ==Case Examples==
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| ===Case #1===
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| ====Clinical Summary====
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| This patient was diagnosed with gout approximately 20 years ago. At that time, he noted the gradual onset of pain in the left knee, followed by swelling, redness and heat, all of which persisted for approximately one month. Shortly thereafter, he had periodic episodes of hot, painful, swollen joints involving the left knee, left ankle, and both first metatarsophalangeal joints. At this time the patient was hospitalized for evaluation of these arthritides. Serum uric acid values on three separate occasions were 8.0, 9.3, and 8.7 mg/dl. In addition to the presence of the painful swollen joints, a gouty tophus was present on the left arm. The patient was readmitted to the hospital from time to time because of acute exacerbations of gouty arthritis. On the most recent hospital admission, a 3-cm tophus was found over the right elbow, as well as several smaller tophi over the right hand.
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| ====Autopsy Findings====
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| The specimen consisted of an elliptically shaped, mottled, yellow-white irregular hard mass, measuring 8.0 x 5.0 x 2.0 cm. in diameter.
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| ====Histopathological Findings====
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| [http://www.peir.net Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
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| [[Image:Gout case 1.jpg|left|thumb|400px|This is a gross photograph of an index finger from a patient with gout. The finger has been sectioned longitudinally to demonstrate the distal interphalangeal joint. Note the white chalky material within and adjacent to the joint (arrows). ]]
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| <br clear="left"/>
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| [[Image:Gout case 2.jpg|left|thumb|400px|This is a gross photograph of the elbow of this patient. The subcutaneous nodules (arrows) on this arm are tophi caused by gout. ]]
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| <br clear="left"/>
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| [[Image:Gout case 3.jpg|left|thumb|400px|This is a low-power photomicrograph of the tophus removed from the elbow of this patient. Note the fibrous connective tissue (1) and the large foci containing the urate crystals (2) surrounded by the intense chronic inflammatory reaction. ]]
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| <br clear="left"/>
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| [[Image:Gout case 4.jpg|left|thumb|400px|This higher-power photomicrograph of the tophus demonstrates the collections of urate crystals (1) and the inflammatory cells at the edge of these foci (2). ]]
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| <br clear="left"/>
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| [[Image:Gout case 5.jpg|left|thumb|400px|This is a higher-power photomicrograph of the edge of the tophus. Most of the urate crystals dissolve away during processing. The inflammatory cells at the edge of these foci are clearly visible (arrow). ]]
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| <br clear="left"/>
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| [[Image:Gout case 6.jpg|left|thumb|400px|This is a high-power photomicrograph of the edge of the tophus. The character of the intense chronic inflammatory cell reaction is evident and note the presence of giant cells within this inflammatory cell reaction (arrows). ]]
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| <br clear="left"/>
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| [[Image:Gout case 7.jpg|left|thumb|400px|This is a photomicrograph of a tophus that was fixed in alcohol prior to histologic processing. The alcohol fixation preserves the water soluble urate crystals within the tissue. Note the urate crystals visible in this photomicrograph (arrows). Also note the chronic inflammatory reaction in the background. ]]
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| <br clear="left"/>
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| [[Image:Gout case 8.jpg|left|thumb|400px|This is a gross photograph of a tophus on the great toe of another patient with gout (arrow). The healed surgical incision and the size of this tophus indicate that this was a long-standing problem for this patient. ]]
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| ==Related Chapters==
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| * [[Pseudogout]] is a very similar disease, but caused by deposition of [[calcium pyrophosphate]], not uric acid.
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| ==External links==
| | {{SK}} Urate crystal arthropathy; uric acid crystal deposition in joint; gouty arthritis; podagra |
| * {{cite web | title=American College of Rheumatology | url=http://www.rheumatology.org/public/factsheets/gout_new.asp?aud=pat| American College of Rheumatology |g publisher= |date=March 23, 2007 | accessdate=2007-03-23}}- (ACR Fact Sheet on Gout)
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| * {{cite web | title=Questions and Answers on Gout from NIAMS| url=http://www.niams.nih.gov/Health_Info/Gout/default.asp | title = Answers and Questions on Gout | publisher= U.S. [[National Institutes of Health]]—[[National Institute of Arthritis and Musculoskeletal and Skin Diseases]] |date=September 28th, 2007 | accessdate=2007-08-28}}
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| * {{cite web | title=Diet and gout | url=http://my.webmd.com/hw/health_guide_atoz/ty2036.asp?navbar=hw69013 | work=A-Z Health Guide | publisher=webMD.com |date=July 01, 2004 | accessdate=2006-09-18}}
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| * {{cite web | title=Coffee Consumption and Reduced Gout Risk | url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=17530645 | work= Drinking coffee reduces risk of gout in middle age men | publisher= U.S. [[National Institutes of Health]] | accessdate=2007-05-25}}
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| * {{cite web | title=Purine content in food | url=http://www.britishdalmatianclub.org.uk/downloads/Purine%20Table%202003_files/sheet001.htm | publisher=British Dalmatian Club | accessdate=2006-09-18}}
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| * [http://health.howstuffworks.com/gout-in-depth.htm Gout in Depth - How Stuff Works]
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| | ==[[Gout overview|Overview]]== |
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| {{Diseases of the musculoskeletal system and connective tissue}}
| | ==[[Gout historical perspective|Historical Perspective]]== |
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| [[Category:Arthritis]] | | ==[[Gout pathophysiology|Pathophysiology]]== |
| [[Category:Rheumatology]]
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| [[Category:Disease]]
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| | ==[[Gout differential diagnosis|Differentiating Gout from other Diseases]]== |
| | ==[[Gout epidemiology and demographics|Epidemiology and Demographics]]== |
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| | ==[[Gout risk factors|Risk Factors]]== |
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| [[ar:نقرس]] | | ==[[Gout screening|Screening]]== |
| [[bg:Подагра]]
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| [[cs:Dna]]
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| [[da:Gigt]]
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| [[de:Gicht]]
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| [[es:Gota (enfermedad)]]
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| [[eo:Podagro]]
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| [[fa:نقرس]]
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| [[fr:Arthrite goutteuse]]
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| [[io:Kiragro]]
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| [[id:Gout]]
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| [[it:Gotta]]
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| [[he:שיגדון]]
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| [[lb:Giicht]]
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| [[ms:Gout]]
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| [[nl:Jicht]]
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| [[ja:痛風]]
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| [[no:Urinsyregikt]]
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| [[pl:Dna moczanowa]]
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| [[pt:Gota (doença)]]
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| [[ru:Подагра]]
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| [[sk:Dna]]
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| [[sr:Гихт]]
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| [[fi:Kihti]]
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| [[sv:Gikt]]
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| [[te:గౌటు]]
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| [[tr:Gut hastalığı]]
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| [[zh:痛风]]
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| | ==[[Gout natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| {{WikiDoc Help Menu}}
| | ==[[Diagnosis]]== |
| {{WikiDoc Sources}}
| | [[Gout staging|Staging]] | [[Gout history and symptoms|History and Symptoms]] | [[Gout physical examination|Physical Examination]] | [[Gout laboratory tests|Laboratory Findings]] | [[Gout electrocardiogram|Electrocardiogram]] | [[Gout x ray|X Ray]] | [[Gout CT|CT]] | [[Gout MRI|MRI]] | [[Gout echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Gout other imaging findings|Other Imaging Findings]] | [[Gout other diagnostic studies|Other Diagnostic Studies]] |
| | ==[[Treatment]]== |
| | [[Gout medical therapy|Medical Therapy]] | [[Gout surgery|Surgery]] | [[Gout primary prevention|Primary Prevention]] | [[Gout secondary prevention|Secondary Prevention]] | [[Gout cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Gout future or investigational therapies|Future or Investigational Therapies]] |