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Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...

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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...

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Updated: Oct 13, 2025

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

Treatment advances in gout.

Lisa K Stamp¹, Hamish Farquhar¹

¹Department of Medicine, University of Otago Christchurch, PO Box 4345, Christchurch, 8140, New Zealand.

Best Practice & Research. Clinical Rheumatology

|November 10, 2021

Summary

Effective gout management requires lowering serum urate to prevent flares and joint damage. Despite new treatments, physician under-prescribing and poor patient adherence hinder optimal outcomes for gout patients.

Area of Science:

Rheumatology
Pharmacology

Background:

Gout management aims to relieve acute flares, prevent recurrence via serum urate reduction, and minimize joint damage.
Despite available therapies, suboptimal outcomes persist due to underutilization of urate-lowering therapy (ULT) and poor patient adherence.

Purpose of the Study:

To review recent advancements in gout management.
To discuss clinical guidelines, safety/efficacy of specific agents, and knowledge gaps in current gout treatment strategies.

Main Methods:

Literature review of recent clinical guidelines and research on gout pharmacotherapy.
Analysis of factors contributing to suboptimal gout management.

Main Results:

Several new medications for gout are available, with ongoing investigation into novel agents.

Keywords:

Flares Gout Treatment Urate lowering

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Physician under-prescribing of ULT and patient non-adherence are significant barriers to effective gout control.

Conclusions:

Optimal gout management necessitates addressing physician prescribing patterns and improving patient adherence to urate-lowering therapy.
Further research is needed to clarify the safety, efficacy, and optimal use of existing and emerging gout treatments.