Gout

Highlights: The first liquid solution of colchicine for prophylaxis of gout, the first generic version of Advair Diskus, and 8 more new and approved drugs.

COPD… nasal polyps.. gout …. dyskinesia in Parkinson Disease: here’s a brief look at new drugs for these and other disorders coming your way.

A quick review of: a great mobile ECG reference; a gout Dx tool; a contraception counseling aid; FPNotebook on mobile; and Klara.

Use this short test to gauge how much you’ve learned about a condition that needs more primary care involvement.

Can you spot the x-ray evidence to detect the suspected diagnosis?

Preventing further acute attacks and decreasing the tophi burden becomes a secondary goal.

Primary care can do more to help reduce gout morbidity, says a new review-plus 4 more studies on gout treatment and prevention.

The faster the attack is recognized and treated with medications, the easier it is to control.

Clinical presentation, history, and laboratory evaluation can make a diagnosis of gout, but crystal examination is the “gold standard.”

How to regulate “the king of diseases and the disease of kings” is this Patient Care Special Report's domain.

Test your knowledge of new American College of Physicians recommendations for improving diagnosis and management.

New evidence-based clinical practice guidelines offer some strong-and not so strong-recommendations for effective gout diagnosis and treatment.

A large population-based study found more patients already had atrial fibrillation at gout diagnosis compared with controls.

For key facts and figures about musculoskeletal disorders, perhaps a surprise as the fourth leading diagnostic category in primary care, see the pages that follow.

Once a disease of kings, gout affects an increasing number of “commoners”-and the physical and economic toll is high.

Here: 5 questions that test your knowledge of gout, psoriasis, COPD, and dermatologic lesions.

Becoming familiar with recent developments in managing “the king of diseases and the disease of kings” may help.

In an era characterized by an expanding array of expensive gout therapies, it may be that cherries have been overlooked.

Gout guidelines recently approved by the American College of Rheumatology have a 2-part focus. They offer patients information on effective methods for preventing gout attacks, and they provide physicians with recommended therapies for long-term disease management.

Here: a concise summary of dosing recommendations for the array of pharmacologic options now available to treat gout.

Gout is associated with a 57% increased risk of ESRD, independent of hypertension and diabetes, according to new research.

Elevated serum uric acid level is pathognomonic for gout. Untreated gout may lead to tophi, nephropathy, and uric acid nephrolithiasis.

A definitive gout diagnosis is based on demonstration of monosodium urate crystals on aspiration of an affected joint or tophus.

Purine-rich foods have now been fingered as perpetrating acute gout attacks as well as chronic gout. A pair of French rheumatologists propose that we may be focusing on the wrong dietary component.

Unfortunately, the growing epidemics of hypertension and gout are often a package deal. Recent data demonstrate that 74% of people with gout are also hypertensive.

Gout, once considered a disease of kings, is now a common and equal opportunity disease that affects as many as 3 million people in the US. Gouty arthritis has now become a serious problem in organ transplant recipients; in diuretic users; and in patients with CKD, hypertension, metabolic syndrome, heart failure, plus more.

About 70% of patients with gout are treated exclusively in the primary care setting. Because the prevalence of gout is rising, particularly among older patients, you are increasingly likely to encounter this disease in your practice.

In the third podcast in this 3-part series, Dr Lieberman describes the options for treatment of an acute flare and for long-term urate-lowering therapy. The first step is lifestyle modification, and he discusses the challenges of motivating patients to institute and adhere to dietary changes.

The gold standard for diagnosis is joint aspiration and synovial fluid analysis; however, compensated polarized light microscopy is not available in most primary care practices. In part 2 of his 3-part podcast, Dr Lieberman discusses the diagnosis of gout in real-world practice.

Gout is a primary care disease. About 70% of patients with gout are treated exclusively in the primary care setting. And because the prevalence of gout is increasing, particularly in older patients, you are increasingly likely to encounter this disease in your practice.