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; if urate-lowering therapy is indicated it may be started during a flare.
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Sources
Reviewed September 2026- 2020 American College of Rheumatology Guideline for the Management of Gout — American College of Rheumatology, 2020
- StatPearls: Gout — StatPearls Publishing / NCBI Bookshelf, 2026
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