question for doctors?

Question

my study is problem-based, I got a case of a male patient presented with severe pain, redness, hotness of his big toe, with no history of trauma....the rest of the case indicates It's gouty arthritis..anyway, while taking history, the doctor asked the patient about any preceding attacks of urinary tract infection or gastroentritis... I need to know what was that question for?

Answer 1

Arthritis is defined as an inflammation of one or more joints. The doctor is asking the patient if there is previous experience or attacks of UTI or gastroenteritis, because it seems like the patient might be suffering from "REACTIVE ARTHRITIS" in which the joints react to an infection elsewhere in the body. Thus, the infection which triggers reactive arthritis is not actually in the joint but usually in the urethra or gut.

I hope this would be of great help.

Answer 2

What you describe sounds, indeed, most classic of podagra, and it sounds like the physician was trying to exclude any factors which might make this patient as a candidate for septic joint, this would be my best guess. The patient would need a tap one way or another, so it's more academic sounding than anything else.

Answer 3

Hmmm-big toe-red inflamed is almost always gout-period. History questioned may have to do with the acidic levels-that in the urine causing imbalances and that in the GI system causing heartburn etc.

Answer 4

UTI could be caused by renal calculi that can also be from uric acid, like gout. Gastroenteritis I'm not sure, but gout and other arthropathies can be related to ulcerative colitis.

Answer 5

Those are infections that could create a relative dehydrated state, and as such could encourage crystallization and concentration of crystals.