Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

White crystals in ulcers - ? gout?

Discussion in 'General Issues and Discussion Forum' started by jollyjoh, May 27, 2007.

  1. jollyjoh

    jollyjoh Member

    Members do not see these Ads. Sign Up.
    Have recently come across about three different cases of ulcers with small chalky white crystals present. Each patient has been referred for blood tests to check for gout.
    One GP's response was that you cannot diagnose gout from the appearance of the foot, or from the presence of crystals, and hence refused to carry out a blood test.
    Each case has not been particularly painful, but the recurrent crystals are preventing healing.

    So, advice please on diagnosis, treatment and management.

    Thanks in advance.
  2. Bruce Williams

    Bruce Williams Well-Known Member

    Tell the MD to get stuffed! White discoloration in a wound, especially at the 1st mpj is almost always from uric acid until proved otherwise.

    Bruce Williams, D.P.M.
  3. W J Liggins

    W J Liggins Well-Known Member

    Strange attitude from the GP!

    If (s)he holds that you cannot Dx gout from the appearance of crystals in a wound, then you most certainly can from blood chemistry. Ignore the G.P., send the patient for bloods at your local private hospital and likewise take a sample of the crystals and send for histo-path analysis.

    When the results come in +ve you can then enjoy yourself writing a nice 'humble' letter to the G.P. with a copy of the reports.

    All the best

    Bill Liggins
  4. Admin2

    Admin2 Administrator Staff Member

  5. drsarbes

    drsarbes Well-Known Member

    The physician said he "Cannot diagnose Gout from the appearance of the foot".......
    well, I would believe him........ of course, the rest of us can.
    Dr. Steve
  6. dsfeet

    dsfeet Active Member

    agree definetly sounds like gout
    had similiar reaction from a gp previously got a x ray and there was gouty destruction ,the gp changed his attitude
    i have found that the best for healing this type of ulcer is idosorb with lyofoam changed evey 3 days. bathe with a weak solution of bicarb soda instead of saline. got this from a conference melb 84 i think its in the abstracts
  7. Foot = gouty
    GP = twit

    If you cannot diagnose gout from the appearance of the foot surely thats a damn good reason to do a blood test. Thats like saying you can't tell somebodies blood sugar by examining their hair so there's no point in doing an HbA1c!*


    *Or indeed
    "if you don't know why I'm angry with you..."
    say it with me boys...
    Obviously you need two proper fully grown X chromasomes for that to make sense. Our runty shrivled little Y chromasomes just don't work as well. :rolleyes:
  8. gangrene1

    gangrene1 Active Member

    Are there any more articles on treatment on gout ulcers?

    I'm really keen to know more about it beside what dsfeet has suggested.
  9. Slava

    Slava Member

    Don't forget about the possibility of it being Pseudogout (Calcium Pyrophosphate Dihydrate deposition diesease) as it can present similar to gout, with white tophy. Pathology testing of crystals is a good idea for diagnosis.
    A blood test for gout or pseudogout may often be negative as the condition may not be in its "active" stages even though joint destructive process has already occured (I have seen this a number of times). In other words experience may tell you that its gout, but a blood test may not back you up.
    Correct diagnosis and treatment of both conditions is essential d/t associated pain of acute attacks and joint destruction as well as associated skin pathology.
  10. lubna

    lubna Welcome New Poster


Share This Page