Physical Exam. Salient Features . History. A 50 y/o was referred for evaluation of azotemia .
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10 yrs ago, he experienced sudden onset of pain on his right big toe. His serum uric acid was elevated. He was diagnosed to have gout and was prescribed medication but he was poorly compliant. The gouty attacks recurred lately hence, he decided to undergo thorough check-up. He denies dysuria, flank pain or hesitancy. He has nocturia.
BP is 120/70
numerous tophi in his metacarpo-phalangeal elbow joint
A 50 y/o obese male diagnosed 10 years ago to have gout with gouty attacks recurring lately and was referred for evaluation of azotemia
Patient experiences nocturia but there is no dysuria, flank pain or hesitancy, and edema
BP is 120/70
Numerous tophi in his metacarpo-phalangeal elbow joint