Follow up

Indications for referral

• Diagnosis uncertainty
• Refractory to conventional therapy despite drug adherence
• Complicated gout with destructive joint changes
• Hypersensitivity or intolerance to allopurinol
• Gout in pregnancy
• Surgical management of tophi when there is uncontrolled infection, entrapment neuropathy & risk of permanent joint damage
• Gout with urolithiasis should be assessed by urologist

Summary Algorithm