GOUT Definition, Causes, Signs,Symptoms,Diagnosis,Prevention, Treatment

What is Arthritis?

There are 127 different kinds of arthritis.

Rheumatoid Arthritis - Severe inflammation that involves many joints and moves beyond musculoskeletal system.

Gout - Very painful form of arthritis characterized by the formation of uric acid crystals and severe inflammation.

Osteoarthritis - Progress be generation of joint cartilage. Minor degree of inflammation.

https://youtu.be/EU-6XcbRyzM



What is GOUT ?

Gout is a metabolic disease in which crystals of uric acid ( monosodium urate) gets deposited in joints and surrounding soft tissues.

Clinical features -

1) Peak age of Onset in Men is 45years.

2) usually after 2230 years of sustained Hyperuricemia.

3) Usually single joint involvement at first , common in 1st Metatarsophalangeal Joint of Great Toe.

4) Other Joints - Ankle,Midfoot,Knee,Small joints of hands and wrist.

5) Severe pain and extreme tenderness.

6) the joints are red hots swollen with shiny overlying skin and dilated veins.

7) Fever , Malaise.

8) Pruritis, Desquamation

9) Initial attacks are Usually self initiated over 5-14 days.



Diagnosis Of Gouty Arthritis.

Diagnosis is confirmed by synovial fluid Aspiration.

The definative diagnosis of gouty arthritis requires aspiration and examination of synovial  fluid from an affected joint using polarized light microscopy to confirm the presence of the needle shaped monosodium urate crystal.


Arthrocentesis - Joint aspiration, is a procedure whereby a sterile needle and syringe are used to drain fluid from a joint.

Prevention -

Once you are diagnostics with Gout , you are a patient of gout for your whole life.

Avoid protein rich diet.

Avoid dehydration - especially in hot weather.

Avoid unaccustomed strenuous exercise.

Care should be taken in patients on long term diuretics and low dose aspirin.



Drug Treatment -


Given to Control levels of uric acid in blood.

To prevent long term complications.

Drug dosage to be adjust according to level of uric acid.


Allopurinol

Is one of the oldest and comment drive use to control the levels of uric acid in blood. This drug inhibits xanthine oxidase which converts xanthine into uric acid.

Probenicid - Promotes excretion of uric acid through kidneys.

Sulphinpyrazone - Promotes excretion of uric acid through kidneys.



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What is UGLY DUCKLING STAGE ? What is Broadbent's Phenomenon? Explanation

UGLY DUCKLING STAGE

EXPLANATION GIVEN ON THE VIDEO.

DEFINATION 

EXPLANATION POINT TO POINT.

TREATMENT

Ugly Duckling Stage

The Ugly duckling stage is a transient or self  correcting malocclusion seen in maxillary
Incisor region between 8 to 9 years of age.


https://youtu.be/f3ETwuLYgHQ

This is a particular situation seen during the eruption of permanent canines.

Eruption of permanent Canines

Radiographic Interpretation of Ugly Duckling Stage

As the developing permanent canine that

displace the root of the Lateral Incisor mesially.

UGLY DUCKLING STAGE

This results in transmitting of force on the root of the Central Incisor which also get displaced mesially.


As a resultant distal divergence of the grounds of two Central Incisor causes a midline spacing. 


This situation has been described by

 Broadbent as Ugly duckling stage.

PARENTS RUSH TO DOCTORS

During this stage children tend to look ugly during the face of development.


Parents are often apprehensive during this stage and consult a dentist.

Self correcting malocclusion

The condition usually correct by itself when the canine erupts and the pressure is transferred from the roots to the coronal area of the incisors.




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