Hi, this is a message from Tom before we get into the regular podcast. I just wanted to let you know that the second edition of the Zero to Finals Medicine book is out now. You can find it on Amazon. If you go direct to Amazon or you can go to Zero to Finals.com slash books to find the links. I started this project back in January this year and I thought I would just go through,

update a couple of guidelines, maybe fix some spelling errors, but I ended up practically

rewriting every single word in the book, adding new topics, adding new Tom tips, adding illustrations,

cutting back on some of the waffle, and the great thing is, it's about the same size.

It costs 25 pounds, the same amount that it did before, and it is so much better. So before we

get started, head over to Amazon and pick up a copy of your book. And let's get into the podcast.

Okay. and let's get into the podcast. Hello and welcome to the Zero to Finals podcast.

My name is Tom and in this episode I'm going to be talking to you about Gout.

And you can find written notes on this topic at zero to finals.com slash gout

or in the Rheumatology section of the second edition

of the zero to finals medicine book. So let's get straight into it. Gout is a crystal

arthropathy associated with chronically high uric acid levels in the blood.

Urate crystals are deposited in the joint, causing it to become inflamed.

Gout typically presents with a single, acute, hot, swollen and painful joint.

The critical differential diagnosis for this presentation is septic arthritis with infection in the joint.

Gouty tofi are subcutaneous uric acid deposits typically seen on the hands, elbows and ears under the skin.

Let's go through the risk factors. The risk factors for gout are being male, family history, obesity, a high pureine diet,

for example with lots of meat and seafood, alcohol, diuretic use, cardiovascular disease and kidney disease.

Let's talk about the typical joints.

The most commonly affected joints are the base of the big toe, which is the metatarsophalangial

joint or MTP joint, the base of the thumb, which is the carpo-metacarpal joint,

or the CMC joint, and the wrist. Gout can also affect the larger joints, for example the knee

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