When should consultations be considered for gout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Rheumatologists should be involved in the care of patients with difficult gout, as advised in the ACR guidelines. They can establish the diagnosis with arthrocentesis and synovial fluid analysis for crystals. They also are skilled in the management of this disorder, and consultation may be helpful for patients with an acute gout attack that does not respond to NSAIDs within 2 days or to colchicine within 1 day, as well as for patients with refractory hyperuricemia.

Rheumatology or orthopedic consultation is indicated for any patient with septic arthritis or for any patient in whom a septic arthritis cannot be ruled out.


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