Gout Author: Grace P. Teal, MD; Howard A. Fuchs, MD
Editorial changes - 2009-09-02
Author information and module status
Prevention
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Hospitalization
  • Hospitalize patients with suspected septic joints for appropriate management until sepsis has been excluded.
  • Consider hospitalizing patients with a gout attack who are immobilized by pain that cannot be controlled with outpatient analgesics.

Hospitalize patients with suspected septic joints for appropriate management until sepsis has been excluded. C

  • Hospitalize patients for possible septic arthritis if the clinical picture is compatible with infection or synovial fluid analysis cannot immediately exclude it.
  • Treat empirically with appropriate intravenous antibiotics; continue treatment if infection is confirmed and discontinue it if infection is disproved.
  • Repeat synovial fluid analysis for cell count, bacterial culture, and presence or absence of monosodium crystals to establish a definitive diagnosis.
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Consider hospitalizing patients with a gout attack who are immobilized by pain that cannot be controlled with outpatient analgesics. C

  • Consider hospitalizating patients with gout who have severe pain not relieved by oral nonsteroidal anti-inflammatory drugs or narcotics, in order to administer intravenous narcotics or ketorolac.
  • Recognize that aspiration of the joint may improve pain if sufficient fluid is removed to decrease intra-articular pressure.
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FAQs
Grace P. Teal, MD (deceased) has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Howard A. Fuchs, MD, is a consultant for TAP Pharmaceuticals.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.

The information included herein should never be used as a substitute for clinical judgment and does not represent an official position of ACP. Because all PIER modules are updated regularly, printed web pages or PDFs may rapidly become obsolete. Therefore, PIER users should compare the date of the last update on the website with any printout to ensure that the information being referred to is the most current available.
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