Gout
Acute gouty arthritis treatment pearls
- NSAIDs, if contraindications then topical still great for single joint
- Colchicine (1.8mg a day) at a low dose, can be used chronically. Remember SEs (sepsis, home marrow suppression. Mostly D&V)
- Steroids
Arthrocentesis: Reasons to tap that joint…
Indications:
- fluid for analysis
– infection
– crystals…
- drain tense haemarthroses
– trauma
– hemophilia (only after factor replacement)
– evaluate communication with a wound
– instillation of analgesics (remember you can inject morphine in a joint) or anti-inflammatory agents
Contraindications (pretty much all relative):
- cellulitis over the joint
- coagulopathy (but with small needle, it’s well described)
- prosthetic joint (you really want ortho involved here)