In a patient with gouty ahritis, synol fluid aspiration will show -
Gout: Disturbed purine metabolism leading to ecxessive accumulation of uric acid in the blood -an inherited disorder ;or impaired excretion of uric acid by kidneys.result is accumulation of sodium bicarbonte crystals in soft tissues. Tisues of predliction are cailages,tendon ,bursa. Patient ,beyond 40 years of age, presents as 1.ahritis-MP joint of big toe is ourite site,acute severe pain 2.bursitis-commonly of olecranon bursa 3.tophi formation deposit of uric acid salt in soft tissue. Confirmation of diagnosis: urate crystals in aspirate from a joint or bursa,high serum uric acid levels Treatment: NSAIDS,uricosuric drugs,uric acid inhibitors. IMAGE SHOWING MONOSODIUM URATE CRYSTALS IN NEGATIVELY BIFRINGENT REF:Essential Ohopaedics.Maheswari &Mhaskar.Edition 9 .Pg no:293
Monosodium Urate crystals
Calcium Pyrophosphate crystals
Mononuclear Leucocytosis
Polymorphonuclear Leukocytosis
Joint disorders