A crystal conundrum: a review of investigation and management of gout for the hand surgeon

Gout is a common cause of arthritis, and flares can present with a variety of clinical manifestations. These can include red, hot and swollen joints that can be difficult to differentiate from other conditions, meaning such patients often come to the attention of hand surgeons. However, as it is common, understanding potential clinical presentations and current approaches to diagnosis and management is important. Presented here is a review of the recent literature on the pathogenesis, clinical presentation, diagnosis and management of gout from the perspective of the hand surgeon. Gout can mimic many different pathologies, both inside and outside the joint, particularly infection. A low index of suspicion is required to investigate appropriately; the gold standard diagnostic investigation remains demonstration of uric acid crystals in the target sample. Level of Evidence: Not ratable.