Gout

@article{Roddy2013Gout,
  title={Gout},
  author={Edward Roddy and Christian D. Mallen and Michael Doherty},
  journal={BMJ : British Medical Journal},
  year={2013},
  volume={347}
}
Gout is the most common inflammatory arthritis, affecting 1-2% of the population. Acute gout is one of the most painful forms of arthritis and is characterised by the abrupt onset of severe joint pain (classically the first metatarsophalangeal joint), swelling, and erythema. The major risk factor is a raised serum urate concentration (hyperuricaemia), which results in the deposition of monosodium urate crystals in and around joints. Untreated, continuing crystal deposition can result in… 
16 Citations
The Use of Cryotherapy in the Gout Pain Control: A Systematic Review
TLDR
Clinical signs of gouty arthritis occur as a result of this inflammatory response to crystals, with clinical picture showing local symptoms of acute arthritis, such as pain.
A crystal conundrum: a review of investigation and management of gout for the hand surgeon
TLDR
A review of the recent literature on the pathogenesis, clinical presentation, diagnosis and management of gout from the perspective of the hand surgeon.
Acupuncture for gouty arthritis
TLDR
A systematic review and meta-analysis will evaluate the effect of acupuncture treatment for patients with gouty arthritis with respect to clinical symptoms, laboratory indicators, and safety, and establish the evidence of acupuncture to treat goutY arthritis.
Prescription Opioid Use Among Patients With Acute Gout Discharged From the Emergency Department
TLDR
The aim was to assess the burden of opioid use and factors associated with its use among gout patients discharged from the ED.
Expanding the role of Australian community dietitians in gout management
TLDR
The aim of this study was to investigate perspectives of Australian community dietitians on whether their role in gout management could be expanded to improve management and treatment of gout.
Rising Incidence of Acute Hospital Admissions due to Gout
TLDR
Acute gout admissions in England increased between 2006 and 2017, accompanied by increasing prescription of gout therapies, and acute admissions due to RA halved over the same time period.
Obesity, hypertension and diuretic use as risk factors for incident gout: a systematic review and meta-analysis of cohort studies
TLDR
Obesity, hypertension and diuretic use are risk factors for incident gout, each more than doubling the risk compared to those without these risk factors.
Predictors of poor response to urate-lowering therapy in patients with gout and hyperuricemia: a post-hoc analysis of a multicenter randomized trial
TLDR
In patients with gout and hyperuricemia, younger age, higher BMI, and higher baseline SUA are predictors of poor response to ULT, and these findings could help physicians better identify patients who may fail and give individualized treatment precisely.
Developing Modern Pain Therapies
TLDR
Recent progress in the understanding of mechanisms underlying pain is discussed, and how these mechanisms are being targeted to produce modern, specific therapies for pain are discussed.
Intra-articular Injection Administration in UK Ex-professional Footballers During Their Playing Careers and the Association with Post-career Knee Osteoarthritis
TLDR
The study suggests that there may have been excessive use of KIA injections to expedite return to play and this contributed to detrimental long-term outcomes such as KP and TKR post-retirement from professional football.
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References

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TLDR
The proclivity of gout for the first metatarsophalangeal joint is likely to be multi-factorial in origin, arising from the unique combination of the susceptibility of the joint to osteoarthritis and other determinants of urate solubility and crystal nucleation such as temperature and minor physical trauma which are particularly relevant to the foot.
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TLDR
US was less sensitive than MRI to cortical erosions in gout, but better than conventional radiography, and Interobserver reliability when assessed ranged from fair to substantial agreement for soft tissue changes and was very good for assessing tophi, double contour and erosion.
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TLDR
Two-thirds of colchicine-treated patients improved after 48 hours, but only one-third of the patients receiving placebo demonstrated similar improvement; significant differences from placebo were shown after 18-30 hours.
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TLDR
Cold applications may be a useful adjunct to treatment of acute gouty arthritis and due to the small sample size the authors could not show statistically significant improvement in all the variables that tended to suggest that effect was more than simply analgesic.
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TLDR
Colchicine prophylaxis during initiation of allopurinol for chronic gouty arthritis reduces the frequency and severity of acute flares, and reduces the likelihood of recurrent flares.
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TLDR
Evidence suggests intra-articular glucocorticoids may be a safe and effective treatment in osteoarthritis and rheumatoid arthritis and the treatment may be especially useful in people when non-steroidal anti-inflammatory drugs or colchicine are contraindicated.
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TLDR
Decrease in SUA during acute gouty arthritis is associated with increased urinary excretion of uric acid; an inflammatory process may play a role in the mechanism.
Joint and tendon subclinical involvement suggestive of gouty arthritis in asymptomatic hyperuricemia: an ultrasound controlled study
TLDR
These data demonstrate that morphostructural changes suggestive of gouty arthritis induced by chronic hyperuricemia frequently occur in both intra- and extra-articular structures of clinically asymptomatic individuals.
Diagnosis of gout in patients with asymptomatic hyperuricaemia: a pilot ultrasound study
TLDR
There are no accurate predictors of gout in this population and the patients who may benefit from an early urate-lowering therapy intervention are ignored, so patients with asymptomatic hyperuricaemia are ignored.
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