063 - Crystal: Diagnosis and Management of Gout

Session Type: ACR Meet the Professor Sessions
Tuesday, November 8, 2011: 7:45 AM-9:15 AM
W187b (McCormick Place West)

Session Overview:
Gout is the most common inflammatory arthritis in adults.  The importance of an accurate diagnosis should not be underestimated for a number of reasons: the likely need for lifelong therapy; the ability with appropriate treatment to cure gout and the need for reduction of the co-morbidities commonly associated with gout.

The usual presentation of acute gout is that of rapid onset of severe pain, often at night, accompanied by swelling, tenderness and overlying erythema most classically in the first metatarsophalangeal joint. Demonstrating presence of monosodium urate (MSU) crystals in the joint fluid or tophus has been the gold standard for the diagnosis of gout.  However, many physicians do not perform synovial fluid analysis.  The usefulness of the “topical ice” test, classification criteria, laboratory tests and imaging, especially ultrasonography in the diagnosis of gout will be discussed in this talk.

Acutely, anti-inflammatory therapies provide rapid pain relief and resolution of gout flares. Chronically, urate lowering therapies reduce the uric acid pool and, in combination with anti-inflammatory prophylaxis, reduce the risk of flares.  However, for a growing number of patients, current standard treatments are ineffective or are contraindicated, largely due to the presence of comorbidities. Such patients require alternative therapies.

Upon completion of this session, participants should be able to:

  • discuss the usefulness of the “ice” test, evaluation of laboratory tests used in the diagnosis of gout and usefulness of imaging, especially ultrasonography in the diagnosis of gout
  • discuss current treatments for acute and chronic gout
  • discuss treatments in development

Talks:
7:45 AM
Michael A. Becker, University of Chicago Medical Center, Chicago, IL
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