Self Assessment Questions in Rheumatology by Yousaf Ali

Author:Yousaf Ali
Language: eng
Format: epub
Publisher: Humana Press, Totowa, NJ

On examination he has a red tender inflamed first toe with exquisite tenderness. Lab work reveals mild anemia, mild prerenal kidney dysfunction. Uric acid is normal.How would you treat his gout?

Answer: Intraarticular (IA) corticosteroid injection

This patient has acute podagra in the setting of an acute NSAID-induced gastrointestinal bleed. An IA injection of steroid is the optimal management in this patient. Colchicine is contraindicated given the renal impairment and potential to further irritate the GI tract.

Keith MP, Gilliland WR. Updates in the management of gout. Am J Med. 2007 Mar;120(3):221–4. Review.

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