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Gout

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 18 Aug 2025
Última atualização: 17 Nov 2022

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • men ages >40 years
  • use of gout-inducing medication
  • consumption of meat, seafood, or alcohol
  • history of medical condition with high cell turnover rate
  • rapid-onset severe pain
  • joint stiffness
  • foot joint distribution
  • few affected joints
  • swelling and joint effusion
  • tenderness
  • tophi
Detalhes completos

Outros fatores diagnósticos

  • erythema and warmth
  • family history of gout
Detalhes completos

Fatores de risco

  • older age
  • male sex
  • menopausal status
  • consumption of meat, seafood, alcohol
  • use of diuretics
  • use of cyclosporine or tacrolimus
  • use of pyrazinamide
  • use of aspirin
  • genetic susceptibility
  • high cell turnover rate
  • obesity
  • adiposity and insulin resistance
  • exogenous insulin
  • hypertension
  • renal insufficiency
  • diabetes mellitus
  • hyperlipidemia
  • family history of gout
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • arthrocentesis with synovial fluid analysis
Detalhes completos

Investigações a serem consideradas

  • serum uric acid level
  • ultrasound
  • dual energy computed tomography (DECT)
  • x-ray of affected joint
Detalhes completos

Algoritmo de tratamento

AGUDA

acute gout

CONTÍNUA

recurrent gout: 2-3 weeks post acute episode

Colaboradores

Autores

Fadi Badlissi, MD, MSc
Fadi Badlissi

Assistant Professor

Harvard Medical School

Attending Physician

Director of the Musculoskeletal Medicine Unit

Department of Orthopedics & Division of Rheumatology

Beth Israel Deaconess Medical Center

Boston

MA

Declarações

FB has received an honorarium as an advisory board member for Horizon Pharmaceuticals.

Revisores

H. Ralph Schumacher, Jr., MD

Professor of Medicine

VA Medical Center

Philadelphia

PA

Declarações

HRS has been a consultant for a number of pharmaceutical companies that produce drugs that can be used for the treatment of gout. Some companies have supplied HRS with funding. HRS is an author of a number of references cited in this topic.

Ade Adebajo, MD

Associate Director of Teaching and Honorary Senior Lecturer in Rheumatology

Academic Rheumatology Group

Faculty of Medicine

University of Sheffield

Sheffield

UK

Раскрытие информации

AA declares that he has no competing interests.

Martin Underwood, MBBS

Professor of Primary Care Research

Warwick Medical School

Coventry

UK

Раскрытие информации

MU declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

National Institute for Health and Care Excellence. Gout: diagnosis and management. June 2022. [internet publication].Полный текст

FitzGerald JD, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care Res (Hoboken). 2020 Jun;72(6):744-60. Аннотация

Qaseem A, Harris RP, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Management of acute and recurrent gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017 Jan 3;166(1):58-68.Полный текст  Аннотация

Richette P, Doherty M, Pascual E, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017 Jan;76(1):29-42.Полный текст  Аннотация

Статьи, указанные как источники

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