Run the List Gout: Presentation and Workup
Mar 3, 2025
Dr. Michael Pillinger, a rheumatology professor at NYU and an expert in gout, shares valuable insights into the condition's presentation and diagnosis. He discusses a case study of a 55-year-old male patient experiencing an acute gout attack, emphasizing the importance of differential diagnoses. Pillinger elaborates on gout's historical context and the biological mechanisms behind uric acid crystal formation. He also explains the critical role of joint aspiration in diagnosis and explores various imaging techniques to distinguish between chronic and acute gout cases.
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Differential Diagnosis of Acute Arthritis
- Mr. G's acute, swollen, red, and painful toe suggests inflammatory arthritis.
- This presentation could indicate gout, calcium crystal disease, or, most importantly, infection.
Big Toe Pain and Gout
- Gout is a crystal disease primarily affecting the big toe, especially in initial attacks.
- Severe big toe pain is a key indicator of gout, but other diagnoses must be considered.
Gout: A Historical Crystal Disease
- Gout, a crystal disease known since ancient times, involves hyperuricemia and urate crystal formation.
- Crystal formation is complex and not solely dependent on high uric acid levels.