Treatment Guideline Chart
Gout is a condition that resulted from deposition of monosodium urate crystals in various tissues (eg joints, connective tissue, kidney).
The patient experiences acute and chronic arthritis, soft tissue inflammation, tophus formation, gouty nephropathy and nephrolithiasis.
Primary hyperuricemia occurs when uric acid saturation arises without coexisting diseases or drugs that alter uric acid production or excretion, while secondary hyperuricemia is a condition where excessive uric acid production or diminished renal clearance occurs as a result of a disease, drug, dietary product or toxin. 

Gout Treatment

Surgical Intervention

  • In chronic tophaceous gout, surgical options are considered in the following conditions:
    • Advanced tophi deposition resulting in major joint destruction
    • Loss of involved joint movements associated with severe pain
    • Tophi collection causing pressure symptoms (eg carpal tunnel syndrome at the wrist)
    • Tophaceous ulcer
    • Cosmetic (eg ear lobe tophi)
    • Uncontrolled infection


  • Ulceration overlying tophi collection may require debridement depending on the state of the ulcer and/or if there is secondary infection
  • Debridement may need to be repeated and frequent dressings are usually required

Extracorporeal Shockwave Lithotripsy and Percutaneous Nephrolithotomy

  • For treatment of intrarenal stones measuring 5-15 mm or complex staghorn stones
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