Crystal Arthritis

Questions discussed in this category

If a patient who has tolerated allopurinol for a prolonged period of time is subsequently found to be positive for the HLA-B*58:01 gene, how would you manage urate-lowering therapy thereafter?

1 Answer available

Do you prefer allopurinol or febuxostat for patients with chronic kidney disease who are receiving treatment for asymptomatic hyperuricemia?

4 Answers available

Do you avoid hyaluronic acid injections in patients with chondrocalcinosis on imaging?

2 Answers available

Are there certain patients in whom you would avoid initiation of ULT during an acute gout flare?

This question is part of a collaboration with RheumMadness and is specifically in reference to: ULT During Gout Flare.

3 Answers available

Can Milwaukee shoulder present with a large subacromial bursitis, or does it predominantly cause joint effusion/destruction?

1 Answer available

Do you delay pegloticase in a patient with an active gout flare?

2 Answers available

How do you plan to use canakinumab for the treatment of gout?

2 Answers available

How do you approach using DMARDs for patients with CPP arthritis who have frequent flares?

For example, I have a patient who has frequent (monthly) large to medium joint flares (Knee, Ankle) with crystal proven disease. Did not tolerate colc...

1 Answer available

Why are gout flares common in hospitalized patients undergoing diuresis but not commonly observed in cancer patients with hyperuricemia resulting from tumor lysis syndrome?

2 Answers available

How would you manage gout with hyperuricemia >10 mg/dl despite the maximum dose of allopurinol plus probenecid and a prior allergic reaction to pegloticase?

2 Answers available

How would you manage a patient on pegloticase and immunomodulation in whom the uric acid has never dropped below 6?

1 Answer available

What is your approach to treating crowned dens syndrome?

2 Answers available

Do you ever taper or stop urate lowering therapy in patients who have had no gout flares and serum urate persistently below 6 mg/dl?

In patients with CKD, does urate lowering therapy have an effect (positive or negative) on progression of CKD?

1 Answer available

Is concomitant use of azathioprine and febuxostat safe from a bone marrow toxicity standpoint?

4 Answers 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

How would you approach the management of a patient with tophaceous gout who consistently has a serum uric acid under 5 on allopurinol but continues to experience gout flares?

2 Answers available

What is your approach to urate lowering therapy in patient with gout who is on azathioprine (for example, for transplant), where allopurinol and febuxostat are both contraindicated?

1 Answer available

At what point, if at all, do you decrease the frequency of or discontinue pegloticase infusions after achieving persistently low serum urate levels?

1 Answer available

How do you approach transaminase elevations 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 use IL-1 inhibitors to prevent flares of gout or CPPD in patients who experience flares despite prophylaxis with colchicine, NSAIDs, and/or low-dose prednisone?

2 Answers available

Is febuxostat a safe alternative for patients who are HLA-B*58:01 positive and of Han Chinese descent?

1 Answer 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 adding colchicine to a patient who is on a stable statin regimen?

2 Answers available

How do you use colchicine for gout in patients with chronic kidney disease or end-stage renal disease on hemodialysis?

2 Answers available

Do you recommend allopurinol desensitization in gout patients who develop a rash on allopurinol therapy?

2 Answers available

Do you avoid PTH/PTHrP analogs in patients with recurrent/severe CPPD?

2 Answers 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

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?