Gout

Musculoskeletal · ~8% of blueprint

Pathophysiology: Monosodium urate crystal deposition from hyperuricemia → acute inflammatory arthritis.
Signs & Symptoms: Acute monoarthritis — exquisitely painful, red, swollen first MTP (podagra); often nocturnal onset.
Gold Standard Diagnosis: Joint aspiration: negatively birefringent, needle-shaped crystals (gold standard).
First-line Treatment: Acute: NSAIDs, colchicine, or steroids; urate-lowering (allopurinol) for prevention.

High-Yield Pearl

Negatively birefringent needle-shaped crystals = gout; don’t start allopurinol during an acute flare.

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