This is a short presentation on gout and gouty arthritis. This also gives a brief idea about the causes of gout, its clinical features and investigations. This also provides basic information regarding management and prevention of gout and its associated complications Dr.A.Mohan krishna Consultant orthopedic surgeon Apollo hospitals, Hyderabad Appointments: 9247258989 9441184590 www.drmohankrishna.com www.bonesandjointsclinic.com www.healthyjointclub.com

2. Dr. A.MOHAN KRISHNA
M.S.ORTHO, MCh ORTH(U.K)
Consultant Orthopaedic surgeon ,
Trauma, Arthroscopy,
Arthroplasty Surgeon
Apollo hospitals, Hyderabad
Consultant Orthopedic Surgeon at
www.drmohankrishna.com
www.healthyjointclub.com
www.bonesandjointsclinic.com

3. This presentation is solely for educational purpose.
The material included in the presentation
represents educational material for the patients
and not intended for any treatment purpose
DISCLAIMER

4. DESCRIPTION
Gout is a metabolic disease in which crystals of Uric acid
(Monosodium urate) gets deposited in joints , tendons and surrounding
soft tissues.

5. CAUSES
The proteins that we consume in our diet get digested and undergo
various steps of degradation in our body.
Normal
metabolism Purinies
Diet
/proteins
Uric acid
Rise in
levels
Formation
of crystals
Crystals
collect in joint
Rapid pain, swelling
and redness of joint
GOUT
Elimination from the
body:urine/faeces

6. CAUSES
High levels of Uric acid can be produced due to
Intake of protein rich diet- high purine diet
Abnormalities in chemical pathways that leads to
excessive production of uric acid
Certain drugs like Aspirin (Salicylates), Diuretics
(Kidney drugs) interfere with the excretion of uric acid
thereby raising its level in blood

7. SYMPTOMS
Uric acid deposits
as crystals in
joints and tendons
Monosodium
urate crystals
Irritation, Inflammation of
joints and tendon tissue
Joints hot/red/swollen

8. SYMPTOMS
• Big toe of foot: classical location.
• Hot/red and swollen
• Ankles
• Knee
• Elbows
• Joints of hand feet

9. RISK FACTORS
A protein rich diet./A high alcohol intake
Certain races, like Maoris and Polynesian
Obesity.
Conditions that cause high cell turnover, such as polycythaemia
(increased red cells), lymphomas and various other cancers can increase
blood uric acid levels.
Drugs like Diuretics (drugs increasing urine flow) or low dose
salicylates,
Kidney diseases.

10. DIAGNOSIS: History
Sudden onset of severe pain,
swelling and redness of joint
in great toe of the foot.
swelling of joints of foot,
ankles and hands
History of alcohol or red
meat intake a day prior to
painful attack
History of similar episodes in
the past

11. DIAGNOSIS : Examination:
Acute stages
Long standing cases: uric acid crystals
deposit in tendons and tissues – GOUT
TOPHI

12. INVESTIGATIONS
Blood tests
• Rise in uric acid
Fluid examination from swelling
• Uric acid crystals
X-rays
• Long standing cases joint destruction

13. TREATMENT
NSAID’S : Pain killers in
high dose initially to settle
pain and swelling
Colchicine : can be given in
acute attack
Newer drugs to reduce level
of uric acid in blood
Rest to affected joint during
acute phase
Acute attack

14. DRUG TREATMENT
Given to control levels of uric acid in blood.
To prevent long term complications.
Drug dosage to be adjusted according to levels of uric acid.
Allopurinol is one of the oldest
and common drug used to control
the levels of uric acid in blood.
This drug inhibits xanthine
oxidase which converts xanthine
into uric acid.
Probenicid and
Sulphinpyrazone – Promotes
excretion of uric acid through
kidneys

16. PREVENTION
Once you are diagnosed with Gout, you’re a patient of gout for your life.
Avoid Protein rich diet – High Purine foods
Avoid Dehydration: especially in hot weathers
Avoid unaccustomed strenuous exercise.
Care should be taken in patients on long term diuretics and
low dose aspirin.

17. DIET FOR GOUT

18. COMPLICATIONS OF
UNTREATED GOUT
joint damage (Arthritis),
formation of gout tophi (swellings around the joint) and
rare complication of chronic kidney disease

19. UNTREATED GOUT
PATIENT

20. CONTACT
Dr.A.MOHAN KRISHNA
M.S.Ortho., MCh Ortho(U.K).,
Consultant Orthopaedic Surgeon,
Apollo Hospitals,
Hyderabad.
Appointments: Secretary : 09247258989
09441184590
08332936085
www.drmohankrishna.com
www.healthyjointclub.com
www.bonesandjointsclinic.com
Email: bonesandjointsclinic@gmail.com