Patients with tophaceous gout rarely develop ulcers, but when they do occur, these ulcers can be difficult to treat. This case study explores the diagnosis of and treatment options for patients with ulcerated tophaceous gout.
Diagnosing gout can be vexing. Most of the time, the diagnosis is made in the primary care setting where physicians diagnose gout by following one of six classification criteria, with the most widely used one being the 1977 American Rheumatism Association criteria.
Four trials of moderate-quality evidence found no significant improvement in pain control in acute gout with NSAIDs vs COX inhibitors. But there was evidence that patients stopped NSAIDs early because of adverse events.
Gout attacks really do occur more often at night, and here is proof. Theories abound as to why, but effective prophylactic treatments to reduce the risk of nocturnal exacerbations appear to be just what the doctor ordered.