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The Swollen Knee | gout in knee

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Gout and Pseudogout, Joint Pain Everything You Need To Know Dr. Nabil Ebraheim


Educational video describing the condition of gout and pseudogout.
The most common joint affected by gout is the 1st metatarsophalangeal joint. The most common joint affected by pseudogout is the knee joint. Gout and pseudogout are similar problems with different causes.
Gout
Gout is caused by the buildup of uric acid crystals inside a joint. The best test to diagnose gout is with a joint fluid analysis. Elevated uric acid is not a good criterion. 90% of patients suffering from gout are men between the ages of 4060 years.
Gout crystals are needleshaped and negatively birefringent. When placed under polarized light they will be yellow.
Uric acid builds up in the body by two main mechanisms:
1Excessive urate production.
2Diminished urate clearance.
Uric acid is produced from the breakdown of proteins inside the body and from the proteins of food that is eaten.
Precipitating factors
The sudden attack of gout can be brought on by anything that increases the level of uric acid in the blood such as:
•Dehydration
•Increased consumption of alcohol
•Eating large amount of meat or seafood
•Trauma/surgery
Diagnostic testing
•Aspiration and analysis of the joint fluid is the best method for diagnosis.
•There are blood tests such as white blood cell count, Creactive protein, erythrocyte sedimentation rate and uric acid level that are helpful in supporting the diagnosis if elevated, but if normal cannot definitively rule out gout or pseudogout.
Pseudogout
Pseudogout is a metabolic disease where calcium pyrophosphate dihydrate crystals (CPPD) are formed within the joint space. Most often affects the knee, occurs more in older patients. Calcification of fibrocartilage (chondrocalcinosis).
Pseudogout crystals are rhomboid shaped and positively birefringent. Crystals will be blue when placed under polarized light.
Associated conditions:
•Hyperparathyroidism
•Rheumatoid arthritis
•Gout
Gout and pseudogout both show a sudden onset of pain, redness and swelling typically affecting a single joint in 80% of the cases.
Gout symptoms and signs include pain, swelling and arthritis. Patients with gout have periarticular erosions along with the formation of uric acid soft tissue masses in and around the joint which can be seen on xray. Soft tissue tophus deposition with periarticular erosions call “punchout” lesions.
Xrays in pseudogout will show thin calcification in the articular cartilage or menisci, with involvement of the patellofemoral joint. Calcifications of the synovium, tendon and ligaments can also be seen.
Treatment of Gout & pseudogout
•Acute gout: indocine, colchicine (be aware of peptic ulcer)
•Chronic gout: allopurinol (xanthine oxidase inhibitor), colchicine
•Uricosuric drugs such as probenecid which increase uric acid excretion by the kidneys may be helpful.
•Treatment of pseudogout: NSAIDs, intraarticular injections.

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The contents of this video (and logo) are the intellectual property of and were created by Dr. Nabil Ebraheim. The music was provided by a free download.

Gout and Pseudogout, Joint Pain Everything You Need To Know Dr. Nabil Ebraheim

Gout , Pseudogout & Joint Pain Everything You Need To Know Dr. Nabil Ebraheim


Dr. Ebraheim’s educational animated video describes the condition of gout and psuedogout arthritis and joint pain.

Follow me on twitter:
https://twitter.com/!/DrEbraheim_UTMC

Find me on Instagram @OrthoInitiative

Gout, Pseudogout, and Joint Pain
The most common joint affected by gout is the first metatarsophalangeal joint. The most common joint affected by pseudogout is the knee joint. Gout and pseudogout both show a sudden onset of pain, redness, and swelling typically affecting a single joint in 80% of the cases. Gout and pseudogout are similar problems with different causes. Gout is caused by the buildup of uric acid and the deposit of uric acid crystals inside a joint. The best test to diagnose gout is with a joint fluid analysis. Gout crystals are needle shaped and negatively bifringent. When placed under polarized light, they will be yellow. 90% of patients suffering from gout are men between the ages of 4060 years old. Gout symptoms and signs include joint pain, swelling and arthritis. Patients with gout have periarticular erosions along with the formation of uric acid soft tissue masses in and around the joint which can be seen on xray. Soft tissue tophus deposition with periarticular erosions “punchout” lesions. The tophi occurs due to deposition of uric acid crystals. The tophus aspirate may look like tooth paste. The sudden attack of gout can be brought on by anything that increases the level of uric acid in the blood such as: dehydration, increased consumption of alcohol, eating large amounts of meat or seafood, or trauma/surgery. Other risk factors for gout are obesity, hypertension, and diuretics. Red meats, seafood, liquor, beer, all increase the risk of gout. Vegetables, wine, dairy products, and total proteins do not increase the risk of gout. Aspiration and analysis of the joint fluid is the best method for diagnosis. Elevate uric acid is not diagnostic. 80% of people with elevated uric acid will not get a gouty attack. There are blood tests such as white blood cell count, Creactive protein, sedimentation rate, and uric acid level that are helpful in supporting the diagnosis if elevated, but if these levels are normal, it cannot definitively rule out gout or pseudogout. Every time you aspirate a joint and you get synovial fluid, you need to analyze it for cell count differential, find out if you have crystals or not and send the fluid for culture and sensitivity if you suspect infection. It might be difficult to differentiate an acute gouty attach from acute septic arthritis. Patients with an acute gouty arthritis may not have an elevated serum uric acid level. A patient with acute gouty arthritis may present with symptoms and a clinical picture that is similar to septic arthritis. Aspirate the joint fluid, and the joint fluid will look like pus, but it could be gout. The incidence of gout and associated septic arthritis of a joint is low (about 1.5%). The incidence of septic arthritis will increase to 11% or more if the cell count is more than 50,000. We aspirate the joint (aspirate will look cloudy, like pus). We look for crystals and if there is crystals, then it is gout, but the presence of uric acid crystals does not exclude septic arthritis. We look at the cell count (will be high, 50,000 or more). The neutrophil count may be 80% or more (we think there is an infection in addition to gout or maybe gout alone). We need to culture the fluid. After we aspirate the fluid and send the fluid for culture, then we give the patient empiric intravenous antibiotics pending the culture result. Remember that gout and septic arthritis can occur together, but the incidence is low. The incidence will increase significantly if the cell count is more than 50,000. Pseudogout or chondrocalcinosis is the deposition of calcium pyrophosphate dihydrate crystals in the hyaline cartilage or fibrocartilage (CPPD). Pseudogout is a metabolic disease where calcium pyrophosphate dehydrate crystals (CPPD) are formed within the joint space. Pseudogout most often affects the knee, occurs more in older patients, and is a calcification of fibrocartilage (chondrocalcinosis). Pseudogout crystals are rhomboid shaped and positively birefringent. Crystals will be blue when placed under polarized light. Associated conditions include hyperparathyroidism, rheumatoid arthritis, and gout. Aspirate to see if it is pseudogout or infection, because you do not want to inject the knee with steroids when there is an infection. You need to look for the rhomboid crystals of pseudogout. Xrays in pseudogout will show thin calcification in the articular cartilage or menisci. Calcifications of the synovium, tendon, and ligaments can also occur. Acute gout can be treated with indomethacin or colchicine if the patient cannot tolerate NSAIDs. Colchicine inhibits the inflammatory mediators and is indicated if the patient cannot tolerate indomethacin. Chronic gout can be treated with allopurinol to prevent buildup of uric acid.

Gout , Pseudogout & Joint Pain Everything You Need To Know Dr. Nabil Ebraheim

Elbow & Knee Bursitis Caused By Gout Everything You Need To Know Dr. Nabil Ebraheim


Dr. Ebraheim’s educational animated video describes the conditions of elbow and knee bursitis which may cause gout.

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Elbow & Knee Bursitis Caused by Gout
Gout can cause bursitis. Gouty bursitis involving the olecranon and prepatellar areas is the most common. Gout crystals within the fluid are needle shaped and negatively bifringent. The presence of crystals within the bursa does not exclude the presence of infection. The fluid white cell count is usually lower within the bursa than anticipated in the joints. When you aspirate the bursitis, the fluid must be sent for culture and sensitivity, cell count and crystals. Gouty bursitis can be bilateral, and it can be difficult to treat. The gouty bursitis may also be associated with infection.

Elbow & Knee Bursitis Caused By Gout Everything You Need To Know Dr. Nabil Ebraheim

Acute Gout Treatment How You Can Relieve the Sudden Onset of Pain (5 of 6)


When a Gout flare occurs, there is much swelling and pain of the joints. This video discusses the treatment options that are available for such an event and prevention for future attacks.

Acute Gout Treatment How You Can Relieve the Sudden Onset of Pain (5 of 6)

The BEST Video About Gout Ever Made


The BEST Video About Gout Ever Made

Bob and Brad discuss various triggers for gout, but also want your input on what has triggered your gout.

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The BEST Video About Gout Ever Made

Gout, Arthritis & Joint Pain Everything You Need To Know Dr. Nabil Ebraheim


Educational video describing the condition of gout and pseudogout.
The most common joint affected by gout is the 1st metatarsophalangeal joint. The most common joint affected by pseudogout is the knee joint. Gout and pseudogout are similar problems with different causes.
Gout is caused by the buildup of uric acid crystals inside a joint. The best test to diagnose gout is with a joint fluid analysis. Elevated uric acid is not a good criterion. 90% of patients suffering from gout are men between the ages of 4060 years. Gout crystals are needleshaped and negatively birefringent. When placed under polarized light they will be yellow. Uric acid builds up in the body by two main mechanisms:
1Excessive urate production.
2Diminished urate clearance
Uric acid is produced from the breakdown of proteins inside the body and from the proteins of food that is eaten. The sudden attack of gout can be brought on by anything that increases the level of uric acid in the blood such as:
•Dehydration
•Increased consumption of alcohol
•Eating large amount of meat or seafood
•Trauma/surgery
Aspiration and analysis of the joint fluid is the best method for diagnosis. There are blood tests such as white blood cell count, Creactive protein, erythrocyte sedimentation rate and uric acid level that are helpful in supporting the diagnosis if elevated, but if normal cannot definitively rule out gout or pseudogout.
Pseudogout or chondrocalcinosis is the deposition of calcium pyrophosphate dihydrate crystals in the hyaline cartilage or fibrocartilage (CPPD). Pseudogout is a metabolic disease where calcium pyrophosphate dihydrate crystals (CPPD) are formed within the joint space. Most often affects the knee, occurs more in older patients. Calcification of fibrocartilage (chondrocalcinosis).pseudogout crystals are rhomboid shaped and positively birefringent. Crystals will be blue when placed under polarized light. Associated conditions:
•Hyperparathyroidism
•Rheumatoid arthritis
•Gout
Gout and pseudogout both show a sudden onset of pain, redness and swelling typically affecting a single joint in 80% of the cases. Gout symptoms and signs include pain, swelling and arthritis.
Patients with gout have periarticular erosions along with the formation of uric acid soft tissue masses in and around the joint which can be seen on xray. Soft tissue tophus deposition with periarticular erosions call “punchout” lesions. Xrays in pseudogout will show thin calcification in the articular cartilage or menisci, with involvement of the patellofemoral joint. Calcifications of the synovium, tendon and ligaments can also be seen.
Treatment of Gout & pseudogout
•Acute gout: indocine, colchicine (be aware of peptic ulcer)
•Chronic gout: allopurinol (xanthine oxidase inhibitor), colchicine.
•Uricosuric drugs such as probenecid which increase uric acid excretion by the kidneys may be helpful.
•Treatment of pseudogout: NSAIDs, intraarticular injections.

Become a friend on facebook:
http://www.facebook.com/drebraheim

Follow me on twitter:
https://twitter.com/!/DrEbraheim_UTMC

The music was provided by a free download.
Author: socreative.tv

Gout, Arthritis & Joint Pain Everything You Need To Know Dr. Nabil Ebraheim

GOUT KNEE ARTHRITIS


This video is about the Gout in knee arthritis and arthroscopic treatment

GOUT KNEE ARTHRITIS

GOUT, Causes, Signs and Symptoms, Diagnosis and Treatment.


Gout is a form of inflammatory arthritis characterized by recurrent attacks of a red, tender, hot, and swollen joint. Pain typically comes on rapidly, reaching maximal intensity in less than twelve hours.The joint at the base of the big toe is affected in about half of cases. It may also result in tophi, kidney stones, or urate nephropathy.

Gout is due to persistently elevated levels of uric acid in the blood. This occurs from a combination of diet, other health problems, and genetic factors. At high levels, uric acid crystallizes and the crystals deposit in joints, tendons, and surrounding tissues, resulting in an attack of gout. Gout occurs more commonly in those who regularly eat meat or seafood, drink beer, or are overweight.Diagnosis of gout may be confirmed by the presence of crystals in the joint fluid or in a deposit outside the joint. Blood uric acid levels may be normal during an attack.

Treatment with nonsteroidal antiinflammatory drugs (NSAIDs), steroids, or colchicine improves symptoms. Once the acute attack subsides, levels of uric acid can be lowered via lifestyle changes and in those with frequent attacks, allopurinol or probenecid provides longterm prevention.Taking vitamin C and eating a diet high in lowfat dairy products may be preventive.

GOUT, Causes, Signs and Symptoms, Diagnosis and Treatment.

What Happens During a Gout Attack | WebMD


Learn more about gout symptoms: https://wb.md/3lX9aeU
Gout attacks usually strike a single joint, like your big toe or a knee. Here’s what’s happening when one hits.

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What Happens During a Gout Attack | WebMD

The Swollen Knee


In this video the knee joint aspiration procedure is demonstrated. A six inch spinal needle is required to remove fluid from this patient’s large swollen knee.

The Swollen Knee

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#Swollen #Knee.

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