Surgical Options for Tophaceous Gout
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Questions and Answers

What is the primary target in the medical management of gouty tophi?

  • Reducing joint destruction
  • Promoting acute exacerbation
  • Dissolving MSU crystals (correct)
  • Increasing sUA levels

    • What is a significant concern when starting medical therapy for tophi?

  • Patient resistance (correct)
  • High sUA levels
  • Renal impairment
  • Tendon transfer

    • What is the primary advantage of newer techniques like arthroscopic debridement and endoscopic resection over open debridement?

  • Lead to increased morbidity
  • Require less postoperative wound care (correct)
  • Offer better long-term results
  • Result in more joint destruction

    • In the medical management of gouty tophi, what can high sUA levels cause?

    <p>Supersaturation of urate</p> Signup and view all the answers

    What is a common preventative measure for acute gouty tophus flare in medical management?

    <p>Increased dose of NSAIDs</p> Signup and view all the answers

    When should prophylaxis with colchicine last in the management of gouty tophi?

    <p>3-6 months</p> Signup and view all the answers

    What is a potential issue with surgical excision of tophi over a joint?

    <p>It can lead to acute gout flare</p> Signup and view all the answers

    What is a limitation of lesion excision as a surgical option for tophaceous gout?

    <p>Rapid lesion recurrence rates</p> Signup and view all the answers

    Why should surgical excision of tophi be performed in close consultation with a rheumatologist?

    <p>To manage and prevent acute gout flares</p> Signup and view all the answers

    Which surgical method is more effective for chronic tendinous tophi?

    <p>Tendon release or transfer</p> Signup and view all the answers

    What may still remain in surrounding soft tissues after surgical options like joint arthroplasty are performed?

    <p>Tophaceous material and chronic synovitis</p> Signup and view all the answers

    What is an effect observed when excising larger tophi according to Kolker et al.'s study?

    <p>Predictable healing and pain alleviation</p> Signup and view all the answers

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