Gout | SOP Information, SOPs and Supporting Information – alphabetic listing, C to D, Carpal Tunnel Syndrome F036, Factors in CCPS as at 9 January 2013 (F036)

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Gout

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Last amended 
25 May 2015

Carpal tunnel syndrome - Gout Factor

Gout is a recurrent acute arthritis of peripheral joints that results from the deposition, in and about the joints and tendons, of crystals of monosodium urate [MSU].  In rare cases the sacroiliac or cervical spine is involved.  The presence of a raised serum urate level is a prerequisite for the development of gout, but, in the absence of arthritis, it does not indicate the clinical onset of gout.

RMA SOP definition of gout

Signs and symptoms

·    The onset of gout usually consists of the appearance of exquisitely painful arthritis generally affecting one joint at first, associated with serum urate in excess of 7.0 mg/dL.

·    Acute pain, often at night, is usually the first symptom.  The pain becomes progressively more severe each hour and is often described as throbbing, crushing, or excruciating.

·    Examination reveals swelling, warmth, redness and exquisite tenderness of the affected joint.

·    The attack may last a day or two, or up to several weeks, but characteristically resolves completely.  Some individuals may never experience another attack.  Usually, however, there follows the "inter critical period" during which the sufferer is totally free of symptoms.  This period may last from one to forty years.  It ends with the occurrence of successive attacks of gouty arthritis, each of which may last longer and resolve less completely than its predecessors.

Establishing onset

If a veteran or member had gout he or she would probably have sought medical attention at the time of clinical onset.  Such medical treatment would normally be recorded in doctors' notes and/or hospital records.  However, these records may have been destroyed or can no longer be obtained.  Therefore, if there is a reliable history of appropriate medical treatment at a particular time, this generally will be accepted, unless there is contradictory evidence.  Seek medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to gout rather than to some other condition.

LAST REVIEWED FOR CCPS 21 FEBRUARY 2014.

PRELIMINARY QUESTIONS [24033]

17519 there is some evidence that gout may be a factor in the development or worsening of the condition under consideration.

1894     the veteran has gout.

1895     the veteran has gout in other relevant side and site of the body or wrist.

17381  the veteran has established the causal connection between the gout and VEA service for carpal tunnel syndrome.

17388 the veteran suffered from gout in other relevant side and site of the body or wrist at the time of the clinical onset of the condition under consideration.

17382   the veteran has established the causal connection between the gout and VEA service for the clinical onset of carpal tunnel syndrome.

17384  the veteran has established the causal connection between the gout and operational service for the clinical onset of carpal tunnel syndrome.

or

17385  the veteran has established the causal connection between the gout and eligible service for the clinical onset of carpal tunnel syndrome.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

17389 the veteran suffered from gout in other relevant side and site of the body or wrist at the time of the clinical worsening of the condition under consideration.

17383   the veteran has established the causal connection between the gout and VEA service for the clinical worsening of carpal tunnel syndrome.

17386  the veteran has established the causal connection between the gout and operational service for the clinical worsening of carpal tunnel syndrome.

or

17387  the veteran has established the causal connection between the gout and eligible service for the clinical worsening of carpal tunnel syndrome.

CLINICAL ONSET AND OPERATIONAL SERVICE [17384]

1900     the gout is causally related to operational service.

CLINICAL ONSET AND ELIGIBLE SERVICE [17385]

1901     the gout is causally related to eligible service.

CLINICAL WORSENING AND OPERATIONAL SERVICE [17386]

1900     the gout is causally related to operational service.

17390 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the gout in other relevant side and site of the body or wrist is causally related.

CLINICAL WORSENING AND ELIGIBLE SERVICE [17387]

1901     the gout is causally related to eligible service.

17391 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the gout in other relevant side and site of the body or wrist is causally related.