A male patient presents with a painful condition over the foot region as shown in the image.He is also suffering from Kidney stones.
He has a habit of eating food containing meat everyday.The patient is allergic to NSAIDS. In this situation,what can be the treatment of choice?
Ans :D. Steroids
Condition shown: Acute gout
- It is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot, and swollen joint.
- Pain typically comes on rapidly in less than twelve hours.The joint at the base of the big toe is affected in about half of cases. It may also result in tophi, kidney stones, or urate nephropathy.
- Gout is a disorder of purine metabolism, and occurs when its final metabolite, uric acid, crystallizes in the form of monosodium urate, precipitating and forming deposits (tophi) in joints, on tendons and in the surrounding tissues
- Dietary causes account for about 12% of gout, and include a strong association with the consumption of alcohol, fructose-sweetened drinks, meat, and seafood.Other triggers include physical trauma and surgery.
- The rare genetic disorders familial juvenile hyperuricemic nephropathy, medullary cystic kidney disease, phosphoribosylpyrophosphate synthetase superactivity and hypoxanthine-guanine phosphoribosyltransferase deficiency as seen in Lesch-Nyhan syndrome, are complicated by gout.
- Medical conditions
- Metabolic syndrome, a combination of abdominal obesity, hypertension, insulin resistance and abnormal lipid levels, occurs in nearly 75% of cases.
- Diuretics ,niacin, aspirin (acetylsalicylic acid), ACE inhibitors, angiotensin receptor blockers (except losartan), beta blockers, ritonavir, and pyrazinamide,ciclosporin and tacrolimus.
- Options for acute treatment include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and steroids,while options for prevention include allopurinol, febuxostat, and probenecid