GOUT: CAUSE URIC ACID, IN 50% THE INITIAL ATTACK AFFECTS THE BIG TOE (PODAGRA). OTHER JOINTS AFFECTED ARE KNEE, ELBOW, ANKLE AND LESS FREQUENTLY OTHERS. MAY AFFECT ONE JOINT OR UNCOMMONLY MANY JOINTS. DIAGNOSIS IS SUSPECTED CLINICALLY BY SEVERE PAIN AND REDNESS ASSOCIATED WITH THE ATTACK. LAB DIAGNOSIS IS MADE BY FINDING NEGATIVELY BIREFRINGENT NEEDLE LIKE CRYSTALS INSIDE A GRANULOCYTE IN THE SYNOVIAL FLUID FROM AFFECTED JOINT – FINDING IT IN THE SYNOVIAL FLUID ITSELF BUT NOT IN THE WHITE CELL IS SUGGESTIVE BUT NOT DIAGNOSTIC . TREATMENT CAN BE WITH COLCHICINE, INDOMETHACIN, PREDNISONE, INTRA-ARTICULAR STEROID (FOR MONO ARTICULAR GOUT).

Prevention by Allopurinol (Xanthine oxidase inhibitor), Probenecid – uricosuric agent, Colchicine – prevents microtubule formation in cell division during anaphase.