Acute gout is a painful arthritis caused crystalline deposition; it commonly affects patients in their 40s-60s. Although any joint can be affected it is classically described in the MTP of the great toe (Podagra). The differential includes septic arthritis and in a first-time flare or if red flag symptoms are present (such as fever) an arthrocentesis may be required. There are several analgesic options that include NSAIDs, corticosteroids (either PO or IM), colchicine or even narcotic pain medication in severe cases. For recurrent attacks lifestyle modification/medication to reduce uric acid should be considered.

 

acute gouty arthritis

arthrocentesis

calcium pyrophosphate dihydrate crystals

crystalline arthropathy

first metatarsophalangeal joint

gout

hyperuricemia

inflammatory arthritis

metatarsophalangeal joint of the great toe