1 MEDICAL GLOBE E-LEARNING MEDICINE SESSION

Gout is a heterogeneous group of diseases characterized by

hyperuricemia (plasma urate level above 6.8 mg/dL) and
urate crystal deposition in joints and kidneys.

Depending on the etiology of hyperuricemia.

● Primary (idiopathic): Hyperuricemia occurs without any

other disease.
● Secondary: Hyperuricemia occurs in association with
another illness.

2 MEDICAL GLOBE E-LEARNING MEDICINE SESSION

3 MEDICAL GLOBE E-LEARNING MEDICINE SESSION
● Age: Gout usually presents after 30 years of age.
● Duration of the hyperuricemia: Usually not less than
● 20–30 years.
● Genetic predisposition: Primary gout is of multi- factorial
inheritance and runs in families.
● Heavy alcohol intake.
● Obesity.
● Drugs (e.g thiazides) which reduce excretion of urate.
● Lead toxicity.

4 MEDICAL GLOBE E-LEARNING MEDICINE SESSION

5 MEDICAL GLOBE E-LEARNING MEDICINE SESSION
6 MEDICAL GLOBE E-LEARNING MEDICINE SESSION
7 MEDICAL GLOBE E-LEARNING MEDICINE SESSION
8 MEDICAL GLOBE E-LEARNING MEDICINE SESSION
 MORPHOLOGY
Acute inflammation:
It is characterized by edema, congestion and dense
infiltration of synovium by neutrophils. Few lymphocytes,
plasma cells, and macrophages may also be seen.

Monosodium urate (MSU) crystals

● They are long, slender, and needle shaped.
● They are found in the cytoplasm of the neutrophils and
are arranged in small clusters in the synovium.

If not resolved it leads to Tophi.

9 MEDICAL GLOBE E-LEARNING MEDICINE SESSION

Tophi: Pathognomonic feature of gout.

Lesions consisting of large aggregates of urate crystals,

surrounded by inflammatory reactions are known as tophi
and are the pathognomonic of gout.

Microscopy: They consist of aggregations of urate crystals

surrounded by macrophages, lymphocytes, and foreign-
body giant cells.

10 MEDICAL GLOBE E-LEARNING MEDICINE SESSION

11 MEDICAL GLOBE E-LEARNING MEDICINE SESSION
12 MEDICAL GLOBE E-LEARNING MEDICINE SESSION
13 MEDICAL GLOBE E-LEARNING MEDICINE SESSION