Concluded Case

hyperuricemia

40 yrs old lady with swelling and pain in the ankle joint from last 3 weeks suddenly. Serum uric acid is 7 and other Blood parameters are within normal limits. She was prescribed signoflam and enzomac by previous doctor but no improvement at all. How to manage this case.

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Serum uric acid is on higher side Swelling is at tarso-metatarsal joints better point of tenderness should have been pointed with xray foot Yes pt needs mx as GOUT Rx tab fabuoxate 80mg 1od Antiinflamatory like indomethacin Rest to affected foot Restricted diet as green leafy vegetables citrus fruits and high proteins in diet should be restricted

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Serum uric acid is on higher side Swelling is at tarso-metatarsal joints better point of tenderness should have been pointed with xray foot Yes pt needs mx as GOUT Rx tab fabuoxate 80mg 1od Antiinflamatory like indomethacin Rest to affected foot Restricted diet as green leafy vegetables citrus fruits and high proteins in diet should be restricted

Thanx dr Kute Ankush
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Start Febuxostat 40 mg .1 tsb OD.x 3 months. NSAID, containing Tricolchocoside 4 mg..1 tab BID. Doppler study is advices.. S.Creatinine../ Vit-D & S.Calciim values. ??

S creatinine 1.0 Vitamin d is 36 Serum calcium is 9.0
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? ANKLE ARTHROPATHY.. ? GOUT .. NEED'S.. NSAIDS.. COLCHICINE.. STEROIDS..

Tnx Dr Shivraj Agarwal sir
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Try bringing down uric acid levels with Zyloric or Febuxostat Lower limb elevation Active movements Crepe bandage

Achilles tendinitis Gout (arthritis related to excess uric acid)

ACCORDING TO GUIDELINES 2020 FOR GOUT FOR ACUTE GOUT NSAIDS (1LINE) INDOMETHACIN 150MG BD DICLOFENAC 100MG BD COLCHICINE 5MG BD SETERIOD 5MG CHRONIC GOUT ALLOPURINOL ( IF NO H/O OF RENAL FAILURE) FEBUXOSTAT 40MG OD RUSBURICASE PIGLOTICASE

Any history of DM?? Any history of Htn?? Blood pressure and Blood sugar level of patient.??? Meanwhile try to Control uric acid Tab:Febustate 40 mg od Tab:Zerodol sp one bd Foot elevation Hot compression Avoid Pulses and protein intake Mild exercise

? Cellulitis ? Acute flare gout( unlikely) Do a digital x-ray , CBC , ESR, CRP Rx= moxclav+ chymoral+ etoricoxib+mgso4 dressing

X ray should be done

Start TAB. LEXIS TWICE A DAY. TAB. ZYLORIC 100 BD WITH ENZOFLAM AND SEE THE RESULT AFTER, 7 DAY

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