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This week, I spoke off the record with one doctor in the NHS

For chronic prevention of gout, the essential message is that present treatments work in a huge majority of patients and are generally well-tolerated

Despite these data, it should be noted that hypopituitarism remains the only indication for GH administration in adults (Clemmons, Molitch, Hoffman et al., 2014)

doi: 10.1073/pnas.1513853113 84 LehnardtSLachanceCPatriziSLefebvreSFollettPLJensenFEet al

Joint aspiration for laboratory analysis may ultimately be required, as it can identify urate crystals, and Gram stain or culture can confirm/exclude the presence of infection

doi: 10.1016/j.semcdb.2016.11.008 69 ZhangSTeoKYWChuahSJLaiRCLimSKTohWS