Gout

Most common in MALES.

Monosodium urate crystals precipitate into joints due to hyperuricemia.

Hyperuricemia might be caused by:
- high cell turnover
- Von Gierke's disease
- decreased excretion of Uric acid due to thiazide diuretics
- Lesch-Nyhan syndrome
- PRPP excess (phosphorybosil pyrophosphate)


Crystals of monosodium sulphate are:
--- NEEDLE shaped
--- negatively birefringent
--- yellow crystals under parallel light
--- blue when perpendicular light

A___Symmetric.

MTP joint of the big toe ------podagra

TOPHUS: external ear, olekranon bursa, Achilles tendon.

Attack is usually after a binge drinking or a large meal consumption


Treat :
acute: indometacin, colchicine.
chronic: allopurinol, febuxostat, probenecid - uricosurics