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Rheumatology

Crystal Arthritis   

Questions discussed in this category

Do you avoid PTH/PTHrP analogs in patients with recurrent/severe CPPD?
2 Answers available
Do you recommend allopurinol desensitization in gout patients who develop a rash on allopurinol therapy?
2 Answers available
How do you approach adding colchicine to a patient who is on a stable statin regimen?
2 Answers available
What is your approach to treating tophaceous gout in patients whose uric acid is below 5 prior to initiating uric acid lowering therapy?
1 Answer available
How do you approach urate-lowering therapy in patients with advanced chronic kidney disease?
What doses of allopurinol do you use, and how frequently do you titrate the dose?
1 Answer available
Is there any utility in checking HLA-B*5801 in our Black and Asian patients who are already tolerating allopurinol?
1 Answer available
What is your approach for gout flare prophylaxis in patients with diabetes and advanced CKD?
Preference for low dose steroids vs attempting colchicine? 
1 Answer available
Is it ever appropriate to reduce urate lowering therapy dose due to very low urate levels?
Are there implications of reducing urate too much?
1 Answer available
Do you screen for HLA-B*5801 prior to starting allopurinol in patients of backgrounds other than Asian or African-American?
Specifically in patients of Vietnamese background? An association has been shown between HLA-B*5801 and the risk of allopurinol hypersensitivity react...
1 Answer available
How do you counsel patients regarding the cardiovascular risk of febuxostat?
1 Answer available
How do you determine when to transition off pegloticase to other uric acid lowering therapies?
1 Answer available
How do you approach transaminitis with use of allopurinol in gout?
Do you rechallenge with lower dose? What is your tolerance for mild persistent transaminitis?
1 Answer available
Do you eventually stop urate-lowering therapy in gout patients with CKD who start hemodialysis?
1 Answer available
When have you found Dual-Energy CT most useful in evaluating for gout?
3 Answers available
How do you approach dosage changes of allopurinol as a patient's GFR decreases over time?
2 Answers available
Do you correct the synovial fluid white blood cell count for red blood cells, and if so, is there a rough approximation/equation you use?
2 Answers available
In gout, do MSU crystals form only in tissue, or are there circulating microcrystals of MSU within blood vessels?
If so, does this have clinical significance?
2 Answers available
Is it ever appropriate to initiate a higher initial dose of allopurinol (such as 300mg daily) than is typically recommended in gout patients at low risk of allopurinol hypersensitivity syndrome and severe hyperuricemia?
2 Answers available
What are the most effective therapies for CPPD with a "pseudo-RA" pattern?
1 Answer available


Papers discussed in this category

The Journal of arthroplasty, 2008-02
Determining "true" leukocytosis in bloody joint aspiration.
The American journal of medicine, 1984-01
Severe allopurinol toxicity. Description and guidelines for prevention in patients with renal insufficiency.
Arthritis Rheum,
Starting dose is a risk factor for allopurinol hypersensitivity syndrome: a proposed safe starting dose of allopurinol.
Rheumatology (Oxford), 2021 Jan 07
Dual-energy computed tomography versus ultrasound, alone or combined, for the diagnosis of gout: a prospective study of accuracy.
Clinical and experimental rheumatology, 2018
Update on imaging in gout: contrasting and comparing the role of dual-energy computed tomography to traditional diagnostic and monitoring techniques.
The Journal of rheumatology, 2004-12
Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis.
The New England journal of medicine, 2018-03-29
Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout.
Lancet, 2020 Nov 09
Long-term cardiovascular safety of febuxostat compared with allopurinol in patients with gout (FAST): a multicentre, prospective, randomised, open-label, non-inferiority trial.

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