Pathogenesis
Risk Factors
- Male gender
- Obesity
- Chronic kidney disease
- Drugs - diuretics, ethambutol, certain chemotherapeutic agents
- Excess purine-rich foods - beer, shellfish, liver, marmite
- Excess sucrose / fructose intake
- Alcohol excess
Diagnosis
Clinical Signs
- Active monoarthritis - particularly of the first MTP joint (podagra) or tarsal joint
- Asymmetric polyarthritis
- Gouty tophi - particularly over joints; the olecranon bursa at the elbow; the helix of the ear; the infrapatellar and achilles tendons
X-Ray Findings
- Soft tissue swelling
- Joint space preservation (no joint space narrowing)
- Tophi - periarticular radiolucent masses
- Juxta-articular 'punched-out' erosions
- Joint destruction (late)
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