TY  - CHAP
M1  - Book, Section
TI  - Chapter 100. Gout
A1  - Usatine, Richard P.
A1  - Smith, Mindy A.
A1  - Chumley, Heidi S.
A1  - Mayeaux, E.J.
Y1  - 2013
N1  - 
T2  - The Color Atlas of Family Medicine, 2e
AB  - A  91-year-old  woman  arrives  by  ambulance  to  the  emergency  department  because  she  was  experiencing  severe  pain  in  her  right  middle  finger  (Figure  100-1).  History  reveals  that  she  has  had  swelling  of  her  finger  for  approximately  1  year.  Palpation  of  the  distal  interphalangeal  joint  demonstrated  firmness  rather  than  fluctuance.  A  radiograph  of  the  finger  was  ordered  (Figure  100-2).  The  radiograph  and  physical  examination  are  consistent  with  acute  gouty  arthritis  superimposed  on  tophaceous  gout.  The  diagnosis  was  confirmed  by  an  aspirate  of  the  finger  that  demonstrated  negatively  birefringent,  needle-like  crystals,  both  intracellularly  and  extracellularly.  She  was  given  1.2  mg  of  colchicine  followed  by  a  second  dose  of  0.6  mg  after  1  hour.  Her  pain  was  markedly  decreased  in  4  hours.  Her  serum  uric  acid  level  was  determined  to  be  10.7  mg/dL.  The  colchicine  was  used  in  this  case  because  the  risk  of  using  NSAIDs  was  considered  to  be  high  because  of  her  previous  history  of  gastric  bleeding  secondary  to  NSAIDs.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=57676362
ER  -