All are true about gout except
Correct Answer: Is directly related to alcohol consumption
Description: Gout is the most common inflammatory ahritis in men and in older women. It is caused by deposition of monosodium urate monohydrate crystals in and around synol joints due to abnormal purine metabolism . Ref Davidsons 23e p1013 Crystals may be deposited in the joints and soft tissues to produce irregular firm nodules called tophi. These have a predilection for the extensor surfaces of fingers, hands, forearm, elbows, Achilles tendons and sometimes the helix of the ear. Tophi have a white colour , differentiating them from rheumatoid nodules. Tophi can ulcerate, discharging white gritty material, become infected or induce a local inflammatory response, with erythema and pus in the absence of secondary infection. They are usually a feature of long-standing gout but can sometimes develop within 12 months in patients with chronic renal failure. Occasionally, tophi may develop in the absence of previous acute attacks, especially in patients on thiazide therapy who have coexisting OA. Ref Davidsons 23e p1014,1013
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