Gouch

A physician advising his reluctant patient to avoid alcohol Wellcome V0011382.jpg

Gouch is a recurrent inflammatory arthritis so painful that "ouch" is built into the name.[1]


Symptoms


Gouch usually manifests first as podagra: a red, hot, swelling, and painful big toe that makes "walking a bitch." It often happens in the middle of the night for the simple reason that gouch is evil.


Causes


Old-school thinking attributed gouch to elevated uric acid levels due to alcohol, red meat, and seafood, with crystallization at lower temperatures. New-school thinking simply attributes it to the Devil.


Genetics


Screw genetics, it's the Devil, damn it!


Diagnosis


Optional.


Differential Diagnosis


Pneumonia, STEMI.


Treatment


Exorcism, NSAIDs[2], or amputation.


References


  1. Patient Continues to Insist He Suffers from “The Gouch,” Not Gout
  2. Area Emergency Physician Successfully Manages Gout Without Consultation


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