Roger, a 50-year-old come to the clinic complaining of a painful great toe, the
toe hurts on the mildest contact, and he is not able to stand on his foot.
DDx
Gout
Definition
Gout is a syndrome characterized by: hyperuricemia and
deposition of urate crystals causing attacks of acute
inflammatory arthritis
Etiology
There is a causal relationship between hyperuricemia (high urate
level) and gout. Urate is a metabolite of purines and the ionized form
of uric acid (a weak acid at a physiologic pH); hence, uric acid exists
mostly as urate. Hyperuricemia does not always lead to gout, but the
incidence of gout increases with urate level.