Gout in primary care

Gout affects around 1% of people in the UK, most aged over 45 years. The condition, which is five times more common in men than women, usually presents as a painful inflammatory monoarthritis, which can be diagnosed clinically and successfully treated with a high dose of an NSAID. Problems arise when the features are atypical or when high doses of an NSAID are inappropriate. Also; there is no robust evidence to guide when to start prophylactic therapy or what advice to give on lifestyle changes. Here we review current practice and offer advice on managing patients with this increasingly common condition, concentrating on approaches to be taken by the non-specialist.