The Curbsiders Internal Medicine Podcast #489 Live from SHM #Converge2025 Rheumatology for the Hospitalist
65 snips
Jun 30, 2025 
Dr. Kimberly Trotter, an Assistant Professor of Medicine at the University of Chicago and co-director of the Lupus Center, dives into the world of rheumatology, specifically focusing on crystalline arthropathies. She discusses diagnosing gout, including the critical use of uric acid levels and arthrocentesis. Trotter shares insights on effective acute treatments and emphasizes the importance of long-term management and patient education to prevent future flare-ups. Her expertise sheds light on the challenges faced by hospitalists in tackling these conditions.
AI Snips
Chapters
Transcript
Episode notes
Steroid Tapering in Gout Treatment
- Start steroid taper once patient shows clinical improvement; avoid immediate tapering.
- Avoid premade steroid packs due to risk of rebound gout flares.
IL-1 Blockers for Refractory Gout
- IL-1 blockers like anakinra are reserved for patients refractory to standard gout therapies.
- Canakinumab is less used due to high cost despite similar mechanism of action.
Timing of Urate-Lowering Therapy
- Do not start urate-lowering therapy during a first gout flare unless severe CKD or tophi are present.
- Consider starting urate-lowering medications in patients with recurrent flares before hospital discharge.