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Discussion

Gout vs. Cellulitis

I have a resident that has redness, swelling, pain and warmth of his index finger...looks like its spreading into the wrist area. I said he needs to be checked out for cellulitis. DON said 'its gout'. Even though he has no history. He is afebrile, but states that it is very painful and he is unable to move the digit. Either way he needs to be check out by an MD right? How do you make the distinction that it is gout vs. cellulitis without a CBc a uric acid level or a sedrate? I just think she is being to blase about it.

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Still needs to be evaluated. Gout has treatments also. If it is a cellulitis and it is allowed to spread, could be very bad.

I agree, it needs to be checked out. If it's gout, which would surprise me, it can be treated, as babynurse says. If it's cellulitis, then it really needs to be treated promptly, again just as babynurse says!

What could it possibly hurt to get it checked out?? Better be safe than sorry, and don't make the resident go through more pain than necessary.

Your DON, BTW, has no business diagnosing unless she's also an NP. If I were the patient's provider, I'd be pretty perturbed with her if it turned out to indeed be cellulitis and she watched it progress without doing anything.

I agree, it needs to be checked out. If it's gout, which would surprise me, it can be treated, as babynurse says. If it's cellulitis, then it really needs to be treated promptly, again just as babynurse says!

What could it possibly hurt to get it checked out?? Better be safe than sorry, and don't make the resident go through more pain than necessary.

Your DON, BTW, has no business diagnosing unless she's also an NP. If I were the patient's provider, I'd be pretty perturbed with her if it turned out to indeed be cellulitis and she watched it progress without doing anything.

If you are assigned that pt can't you call the doc? I'm sure I need to see the pt will be the answer, and there is your order!

I wouldn't worry about making a distinction between gout and cellulitis. That's not my job! My job would be to get an appt with the doctor ASAP! Period.

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