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Gout is a metabolic arthropathy caused by deposition of monosodium urate (MSU) crystals in joints and soft tissues, due to chronic hyperuricemia. It leads to acute inflammatory arthritis, chronic joint damage, and formation of tophi in advanced stages.
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https://www.youtube.com/watch?v=dEQ-SOoVLz8
https://www.youtube.com/watch?v=lacHGRQzApY
https://www.youtube.com/watch?v=qmIJ5xGX0x4
| Step | Description |
|---|---|
| Purine metabolism | Uric acid is the final product of purine breakdown |
| Hyperuricemia | Uric acid >6.8 mg/dL → supersaturation in plasma |
| MSU crystal deposition | In joints, tendons, and surrounding soft tissue |
| Inflammatory cascade | Crystals trigger neutrophil activation → acute arthritis |
| Phase | Features |
|---|---|
| Acute gout attack | Sudden, intense monoarthritis (classically 1st MTP – podagra), redness, swelling |
| Intercritical gout | Asymptomatic intervals between attacks |
| Chronic tophaceous gout | Visible/palpable tophi, joint deformity, chronic arthritis |
Commonly affected joints:
Diagnostic Criteria (2020 ACR/EULAR):