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Some crystals of learning on gout from Ed Roddy @Keele_PCSC (get it?! 
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Indomethacin no more efficacious than other NSAIDS, worse SEs
Think of gout as a chronic disease of monosodium urate crystal deposition, rather than episodic inflammatory disorder....
@RheumatologyUK
)Indomethacin no more efficacious than other NSAIDS, worse SEsThink of gout as a chronic disease of monosodium urate crystal deposition, rather than episodic inflammatory disorder....@RheumatologyUK
Non-pharma management not only=dietary advice: advise re RFs, consequences of untreated gout 
flare frequency+severity, irreversible damageDietary modification less effective than urate lowering therapy (ULT)Consider+discuss ULT with every pt at 1st presentation
Allopurinol hypersensitivity: age, F, starting dose, HLA B*5801Education key if unable to give prophylaxis during flare (eg CKD CI colchicine)Renal handbook to guide dosingRisk of myelosuppresion AZA + febuxostatAsk Tx team to switch to MMF to facilitate px of ULT
Screening in CPPD age <55, florid presentationHaemochromatosis, hyperparathyroidism, hypoMg2+, hypoP04-, Wilson's
Troublesome long term CPPD (recurrent flares/arthritis): NSAID+PPI, colchicine, low dose steroid, MTX, HCQGreat talk thx v much!
