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Note that serum uric acid may be normal during an acute attack and should be rechecked after the flare resolves Joint aspiration fluid is drawn from the affected joint to examine for urate crystals under polarised microscopy and to exclude septic arthritis Imaging plain X-rays detect joint damage in chronic gout, while ultrasound or Dual Energy CT (DECT) scans can identify crystal deposition in joints and soft tissues even between attacks An accurate diagnosis is essential because other conditions, including septic arthritis and pseudogout, can produce similar common symptoms of inflammation and joint swelling

The key is having your thigh relaxed, not tensed

2,3 Strategies to minimize infant exposure to maternal medication include dosing after breastfeeding and before the longest sleep interval for once-daily medications

Setting realistic expectations prevents premature discontinuation

In recent years there is an appreciation of the advantages of involving patients in healthcare decisions, in contrast to the traditional paternalistic approach to medicine