RheumReferral

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Adults

Asymptomatic hyperuricemia

May not require referralOften managed in primary care

High serum urate without gout. Most people never develop gout.

What to look for

  • Raised urate with no flares, tophi or urate stones

What to do

  • The ACR conditionally recommends against starting ULT for asymptomatic hyperuricemia.
  • Address modifiable factors: alcohol, sugar-sweetened drinks, weight, and medications such as thiazide diuretics.

Refer if

  • A gout flare, tophus or urate stones occur

About this urgency level

Common in referral queues. Many can be managed in primary care with the guidance below, though some rheumatology practices are happy to see them. A pre-referral e-consult can help decide.

Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.

Sources