Gout: NEET PG High-Yield
Crystal Arthropathy: Metabolic Disorder
1. Pathophysiology & Presentation
Gout is caused by the precipitation of monosodium urate (MSU) crystals in the joints due to hyperuricemia.
- Podagra: Inflammation of the 1st MTP joint (the classic presentation).
- Clinical Phases: Asymptomatic hyperuricemia → Acute gouty arthritis → Intercritical gout → Chronic tophaceous gout.
2. NEET PG High-Yield Pearls
| Diagnostic Feature | High-Yield Detail |
|---|---|
| Synovial Fluid | Needle-shaped, negatively birefringent crystals under polarized light. |
| X-ray | “Rat-bite” (punched-out) erosions with overhanging edges. |
3. Management
- Acute Attack: NSAIDs (Indomethacin is classic), Colchicine (best if given within 24 hours), or Corticosteroids.
- Chronic/Prophylactic: Xanthine oxidase inhibitors (Allopurinol or Febuxostat).
- Critical Pearl: Do NOT start urate-lowering therapy (ULT) during an acute attack; wait until inflammation has resolved (or start carefully with anti-inflammatory cover).
4. Resources
For more clinical vignettes and high-yield questions on crystal arthropathies, visit mymedschool.org.