Acute Gout admission

Incidentally found in a patient after 1-2 days of hospitalization but need not necessarily be so. Majority of these patients have CKD or a history of gout prior to admission

Hospitalist: 

Serum Uric Acid

X ray of the joint

Indomethacin 25mg PO every 6hrs if no renal failure

Colchicine PO 0.6mg daily, can cause GI problems

Solumedrol IV or Prednisone PO tapering doses Rheumatology consult if the you are not sure–>Allopurinol later for chronic treatment

Some patients can develop pseudo-gout also after a few days after admission. It gets better with low dose Prednisone.

Always make sure to rule out septic arthritis first.