This study highlights an ongoing challenge in the diagnosis of crystal arthritis and the importance for both the patient and the healthcare system of an accurate diagnosis. The close collaboration via the messaging app allowed rapid, easy multidisciplinary input into these diagnostically challenging cases.
4. Abstract 0273
Barriers & Facilitators for Outpatient Follow-Up After an Acute Gout Flare. Lopez et al.7
It is well recognized that many people with gout present to the emergency department for flare management. However, successful long-term management of gout requires engagement between the patient and their usual healthcare provider to ensure urate-lowering therapy is instituted and target urate is achieved. Lopez et al examined the barriers and facilitators to outpatient follow-up for gout management after an ED visit for a gout flare. Importantly, 7/12 individuals interviewed were Black or African American.
Although the results may not be surprising to many of us, they highlight factors clinicians need to consider. Lack of reliable transportation and the impact of gout on an individual’s physical function to go to clinic were barriers for 75% and 67% respectively. The most important facilitator was the emergency department clinician providing information on gout, including emphasising the need to follow up in the outpatient setting (92%).
The interaction with the emergency department physician at the time of a gout flare is clearly important not only for managing the flare but also for referral to a primary healthcare provider or rheumatologist for ongoing management and education about the importance of long term treatment and follow-up.
Working with our colleagues in the emergency department to ensure that clear messaging is given to patients about the need for urate-lowering therapy and the importance of follow-up is just one piece of the puzzle. Overcoming system and financial barriers is more complex. Gout management guidelines are plentiful, but we need to consider in our own institutions’ settings and the unique populations that we serve how best to implement them.
5. Abstract 1100
Coronary DECT for the Detection of Monosodium Urate Crystal Deposition. Yokose et al.8
Advanced imaging techniques, such as ultrasound and dual-energy CT (DECT), have enabled visualization of monosodium urate (MSU) deposits in joints. DECT has also been used to visualise MSU deposits in other organs, such as the kidneys. In this study, Yokose et al. examined whether people with gout have a higher prevalence of MSU crystals in their coronary arteries than those without gout, using both the default and optimized post-processing DECT settings.
