McMaster Textbook of Internal Medicine

McMaster Textbook of Internal Medicine
Interviews
Rheumatology
Periarticular injections in the treatment of acute gout flares

Periarticular injections in the treatment of acute gout flares

2018-04-05

George Nuki

Are periarticular injections used in the treatment of acute gout flares?

George Nuki: Certainly, intra-articular injections of steroids, as we mentioned [see Currently recommended treatment for gout attacks], can be very effective.

If you have a patient who has an acute bursitis—a prepatellar bursa or an olecranon bursa—that is due to acute gout, then it is certainly not unreasonable to aspirate that joint and inject it. But periarticular injections in somebody who has got simply a bit of cellulitis around the joint is not a good idea at all.

See also

Low-dose colchicine after 12 hours from the onset of gout flare According to the EULAR guidelines, in gout flares colchicine is recommended within 12 hours of the onset of symptoms. Because most patients frequently present after this time, the recommendation concerns self-administration of colchicine and treatment of subsequent flares. Can we use low-dose colchicine if the patient presents after 12 hours from the onset of symptoms? Or should we prefer nonsteroidal anti-inflammatory drugs or steroids?
Imaging studies in patients with PMR Is it necessary to perform imaging studies looking for vasculitides, such as aortitis, in all patients with polymyalgia rheumatica (PMR)? What imaging studies are recommended?
Currently recommended treatment for gout attacks What is the currently recommended treatment for gout attacks?
Current management of gout: Practical messages from 2016 EULAR guidelines This article presents an overview of the key updates in the new EULAR recommendations for the management of gout.
Tailoring therapy in spondyloarthritides A lecture by Prof. Filip Van den Bosch, from Ghent University, Belgium, delivered at McMaster International Review Course in Internal Medicine in Kraków in May 2016.

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