Clinical manifestations, diagnosis and treatment of gout in the practice of a primary care physician

Abstract

Currently, there is a significant increase in the incidence of gout, which is often combined with diabetes, hypertension, obesity, and atherosclerosis, being pathogenetically closely related to them. The increase in the incidence of gout seems to be associated with an increase in the number of patients with hyperuricemia, which is the main factor leading to the development of the disease. Knowledge of risk factors for gout, its clinical manifestations, methods of diagnosis and treatment is very important for a primary outpatient physician, since early diagnosis and adequate therapy of the disease, as well as concomitant pathology, prevents the development of severe cardiovascular complications and complications of gout itself. Currently, both international and national guidelines for the management of gout patients have been developed. The recommendations reflect the main symptoms of gout, features of the course of acute gouty arthritis depending on the patient's gender, as well as changes in the kidneys associated with hyperuricemia. The issues of diagnostics, prevention of the progression of the pathological process, and competent administration of anti-inflammatory and urat-lowering therapy are covered in detail. The article presents the risk factors for the development of gout. Much attention is paid to the description of the main clinical manifestations of gout both in the early stages of its development (acute gouty arthritis) and later (chronic tofus gout). The article presents diagnostic criteria for gout developed by ACR/EULAR, as well as methods of laboratory and instrumental diagnosis of the disease available to the primary outpatient physician. Gout therapy (non-drug and medication) is also multi-purpose. Its main directions (relief of an acute attack, prevention of relapses, urate-lowering therapy and indications for it) are reflected in the article in accordance with current national and international recommendations.