Crystal arthropathies
Red flags
Consider immediate (orthopaedic) referral if
- Suspicion of septic arthritis ie fever, systemic illness
Consider routine referral for
- Polyarticular gout
- Diagnosis uncertain
- Unacceptable symptoms despite adequate management in primary care
For example:
Gout
Pseudogout
Other important information for referring practitioners
Lifestyle changes
- Dietary changes and move towards healthy BMI
- Alcohol reduction and smoking cessation
- Avoid dehydration
- Keep active (NHMRC: moderate intensity activity for 2.5-5h/week)
Medical management (excludes acute gout)
- Treat other relevant conditions e.g. diabetes
- Cease medications that increase uric acid if possible e.g. diuretics
- NSAID +/-colchicine
- Paracetamol +/- codeine as appropriate
- Xanthine Oxidase Inhibitor / uricosuric with appropriate prophylaxis (NSAID/colchicine/corticosteroid) to reduce risk of acute attacks
Referral requirements
A referral may be rejected without the following information.