Gout is a purine metabolism disorder caused by high levels of uric acid in the blood that leads to inflammation. It differs from osteoarthritis, which causes cartilage destruction and inflammation from joint overuse, and osteoporosis, which is defined by low bone mass and increased fracture risk. Gout occurs when uric acid crystallizes and forms monosodium urate crystals that deposit in joints, causing a painful inflammatory reaction. Risk factors include diet high in purines, genetics, obesity, medications, and certain medical conditions. Stages of gout progression include asymptomatic, acute, interim, and chronic.

1. GOUT
MITAL PARMAR

2. DIFFERENCE OF GOUT FROM OTHER BONE
RELATED DISEASES
Gout is a purine
metabolism disorder
in which high levels
of uric acid is
accumulated causing
inflammation.
Osteoarthritis causes
destruction of cartilage
and asymmetric
inflammation caused by
overuse of joint.
Osteoporosis is defined
as low bone mass and
deterioration of bone
tissue which leads to
bone fragility and an
increase in fracture
risk.

3. WHAT IS GOUT?
• Gout is an inflammatory reaction to
monosodium urate crystals (MSU).
• Uric acid is a breakdown product of
purines. Uric acid crystals are formed
when there is an increase in serum uric
acid (SUA) above a specific thershold.
• MSU crystals can be deposited in all
tissues mainly in and around the joints
forming tophi.
• 5% of people with hyperuriceamia above 9
mg/dL develop gout.

4. PATHOPHYSIOLOGY OF GOUT
• Catabolism of purines from diet
and cell breakdown forms uric acid
produced in liver by the action of
xanthine-oxidase enzyme.
• Elevation in production and
reduced excretion of uric acid leads
to hyperuricaemia (abnormal
accumulation of high level of uric
acid in blood).
• Ionised uric acid (urate) reacts with
Na+ ions to form MSU crystals.
• Accumulation MSU crystals in the
soft tissues of joints leads to the
formation of Gout.

6. STAGES OF GOUT
Asymptomatic gout:
-Initiative segment phase of gout.
-Uric acid in blood forms urate crystals.
Acute gout:
- Symptoms starts to occur.
-Causes sudden pain, swollen, redness of the
affected joint.
Intercritical or Interim gout:
- Happens after intense side efects have settled, and
second rate irritation may stay inside the joint,
causing unnoticed harm.
Chronic gout:
-Advanced stage of gout and the pain is frequent.
-Tophi formed between the tissue joints causes
erosion of bone and cartilage and gets hard.

7. POSSIBLE RISK FACTORS OF GOUT

8. FEW SIGNS & SYMPTOMS OF
GOUT

9. GOUT SURGERIES
• a small cut on the skin above the tophus
is made and the tophus is removed by
hand.
Tophi removal
surgery
• smaller joints are fused together.
• is done when chronic gout has
permanently damage a joint.
Joint fusion
surgery
• joint damaged by tophaceous gount is
replaced by artificial joint.
• most common joint replaced which is
damaged by gout is the knee.
Joint
replacement
surgery

10. REFERENCES
• L. Kathleen Mahan, Janice L. Raymond,Krause’s food & the nutrition care
process, 14th edition.
• Kumar, Abbas, Ester, Robbins Basic Pathology, 10th edition.
• Panchatcharam Parthasarathy and S. Vivekanandan, Urate crystal deposition,
prevention and various diagnosis techniques of GOUT arthritis disease:
a comprehensive review.
• https://www.healthline.com/health/gout-
surgery#:~:text=Because%20tophaceous%20gout%20can%20cause,joint%20fusi
on%2C%20or%20joint%20replacement.
• https://www.verywellhealth.com/gout-risk-factors-189835
• https://www.verywellhealth.com/recognize-the-signs-and-symptoms-of-gout-
189846
• https://creakyjoints.org/treatment/gout-stages-progression/

11. THANK YOU!