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The Clinical Features of Gout

  • Bruce N. Cronstein
  • Michael H. Pillinger

Abstract

Gout is caused by the crystal deposition of monosodium urate in and around joint tissues. The first joint affected in the majority of cases is the first metatarsophalangeal joint, a condition known as podagra. Acute gout is characterized by the rapid development of warmth, swelling, erythema, and pain in the affected joint. The natural history of gout is to worsen with time, progressing through the stages of asymptomatic hyperuri-cemia and acute intermittent gouty attacks to tophaceous gout. The time period between the first development of acute intermittent gouty attacks and the appearance of chronic tophaceous gout is approximately a decade in most cases. The development of tophaceous deposits of monosodium urate is a function of the degree and duration of hyperuricemia. However, most people with hyperuricemia never develop clinical gout.

Keywords

Uric Acid Synovial Fluid Familial Mediterranean Fever Serum Uric Acid Level Acute Gout 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Annemans L, Spaepen E, Gaskin M, Bonnemaire M, Malier V, Gilbert T, Nuki G. Gout in the UK and Germany: prevalence, comorbidities and management in general practice 2000–2005. Ann Rheum Dis. 2008;67:960–6PubMedCrossRefGoogle Scholar
  2. Becker MA, Schumacher HR Jr, Wortmann RL, MacDonald PA, Eustace D, Palo WA, Streit J, Joseph-Ridge N. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med. 2005;353:2450–61PubMedCrossRefGoogle Scholar
  3. Ben-Chetrit E, Levy M. Colchicine: 1998 update. Semin Arthritis Rheum. 1998;28(1):48–59PubMedCrossRefGoogle Scholar
  4. Bomalaski JS, Lluberas GR, Schumacher HR Jr. Monosodium urate crystals in the knee joints of patients with asymptomatic nontopha-ceous gout. Arthritis Rheum. 1986;29(12):1480–4PubMedCrossRefGoogle Scholar
  5. Centers for Disease Control and Prevention, national Center for Health Statistics. Vital and health statistics: current estimates from the national Health Interview Survey, 1996. Series 10, No. 200. Atlanta: Department of Health and Human Services (US). Available at http://www.cdc.gov/nchs/data/series/sr_10/sr10_200.pdf
  6. Chen KR, Carlson JA. Clinical approach to cutaneous vasculitis. Am J Clin Dermatol. 2008;9(2):71–92PubMedCrossRefGoogle Scholar
  7. Choi MH, MacKenzie JD, Dalinka MK. Imaging features of crystal-induced arthropathy. Rheum Dis Clin N Am. 2006;32:427–46CrossRefGoogle Scholar
  8. Cronstein BN, Terkeltaub R. The inflammatory process of gout and its treatment. Arthritis Res Ther. 2006;8(Suppl 1):S3PubMedCrossRefGoogle Scholar
  9. Edwards NL. The role of hyperuricemia and gout in kidney and cardiovascular disease. Cleve Clin J Med. 2008;75(Suppl 5):S13–6PubMedCrossRefGoogle Scholar
  10. Famaey JP. Colchicine in therapy. State of the art and new perspectives for an old drug. Clin Exp Rheum. 1988;6(3):305–17Google Scholar
  11. Faraj AA, Omonbude OD, Godwin P. Gram staining in the diagnosis of acute septic arthritis. Acta orthop Belg. 2002;68(4):388–91PubMedGoogle Scholar
  12. Hippocrates. The genuine works of Hippocrates, volumes 1 and 2. Translated and edited by Adams F. New York: Wood; 1886Google Scholar
  13. Molad Y, Cronstein BN, Malawista SE. Colchicine. In: Smyth CJ, Holers VM, editors. Gout, hyperuricemia, and other crystal-associated arthropathies. New York: Marcel Dekker; 1998. p. 193–204Google Scholar
  14. Pascual E, Batlle-Gualda E, Martinez A, Rosas J, Vela P. Synovial fluid analysis for diagnosis of intercritical gout. Ann Intern Med. 1999;131:756–9PubMedCrossRefGoogle Scholar
  15. Shah K, Spear J, Nathanson LA, McCauley J, Edlow JA. J Emerg Med. 2007;32(1):23–26PubMedCrossRefGoogle Scholar
  16. Urano W, Yamanaka H, Tsutani H, Nakajima H, Matsuda Y, Taniguchi A, Hara M, Kamatani N. The inflammatory process in the mechanism of decreased serum uric acid concentrations during acute gouty arthritis. J Rheumatol. 2002;29:1950–3PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Bruce N. Cronstein
    • 1
  • Michael H. Pillinger
    • 2
  1. 1.NYU Langone Medical CenterClinical Pharmacology/Rheumatology/MedicineNew YorkUSA
  2. 2.NYU Medical CenterRheumatology/MedicineNew YorkUSA

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