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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Subcutaneous fat necrosis is a well described, rare sequela of acute pancreatitis. Uncommonly, arthritis is seen in association with these 2 disease processes. We report a case of fulminant pancreatitis presenting as an acute arthritis. Birefringent crystal-like structures led to initial diagnostic confusion with gout.
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PMID:Subcutaneous pancreatic fat necrosis associated with acute arthritis. 159 88

In 1992, the Netherlands Centre for Monitoring of Adverse Reactions to Drugs received 1248 reports of suspected adverse reactions. The most important reports concerned chest pain to sumatriptan, cholestatic hepatitis to itraconazole and taste loss to terbinafine. Other important reports pertained to confusion and hallucinations in children on deptropine, postasphyctic encephalopathy of a newborn after intrapartum administration of nalbuphine, torsades de pointes to terodiline, fever to neuroleptics, muscle necrosis to intramuscular administration of diclofenac, gout during use of acetylsalicylic acid, psychic effects of vigabatrine and sudden death during fluorescence angiography. It is the policy of the Netherlands centre to publish as many relevant reports as possible in order to facilitate medical practitioners to adapt their pharmacotherapeutic choice. In close collaboration with several universities, the Netherlands centre currently develops systems and methods for postmarketing surveillance.
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PMID:[Recording of possible side effects in the Bureau for Side Effects of Drugs and research activities in 1992]. 837 25

The 1987 American College of Rheumatology (ACR) criteria for the classification of rheumatoid arthritis (RA) were clinically assessed. These criteria do not include findings of synovial fluid (SF) analysis and require no exclusion criteria. We have studied sequential patients with arthritis seen in four rheumatology centers in the Philadelphia area. Classifications by the ACR criteria were compared with our clinical diagnoses. Two hundred ninety eight patients were evaluated, 113 with RA and 185 with other diagnoses. Classifications as RA by the ACR criteria corresponded to our clinical diagnosis in 95% of the cases, corroborating the high sensitivity previously reported. However, we found a lower specificity (73%) than that reported (89%). False positive classifications as RA were found in 71% of patients with psoriatic arthritis, 48% of patients with SLE, and 31% of patients with gout. The specificity could be improved to 89% by excluding disorders with obvious distinguishing extraarticular features such as psoriasis or by SF findings of monosodium urate crystals. Awareness of these possible sources of confusion will further increase the teaching and epidemiologic value of these useful simplified criteria.
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PMID:Clinical assessment of the 1987 American College of Rheumatology criteria for rheumatoid arthritis. 922 83

Bilateral rupture of the quadriceps tendon is a rare injury. It usually occurs in obese older patients. Other predisposing factors are long-term chronic renal failure, gout, rheumatoid arthritis, diabetes mellitus, hyperparathyroidism and abuse of anabolic steroids. The most common cause of bilateral rupture is a sudden violent contraction of the quadriceps muscles with the knees semiflexed and the feet fixed. Examination reveals bilateral joint effusion, palpable or visible suprapatellar gaps, and an inability to extend both knees and lift the straight legs. Often the diagnosis is missed, and diagnostic confusion with other causes of inability to use the legs happens. We report one case of simultaneous bilateral rupture where treatment was delayed for several weeks because of diagnostic confusion.
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PMID:[Simultaneous bilateral rupture of the quadriceps tendon]. 962 90

Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is characterized by the accumulation of pyrophosphate dihydrate crystals in articular and periarticular tissues. Various terms have been utilized to describe this arthropathy, which has led to some confusion. CPPD crystal deposition disease is among many conditions that may result in crystal deposition within cartilage. Chondrocalcinosis is a pathologic and radiographic term denoting calcification of cartilage within joints including both hyaline articular cartilage and fibrocartilage. Pseudogout is a clinical term applied to an acute inflammatory process in a joint(s) mimicking a gout attack. Pseudogout is just one of the multiple clinical presentations for CPPD crystal deposition disease. Pyrophosphate arthropathy is a term that has been used to describe the peculiar pattern of joint destruction associated with CPPD crystal deposition disease. This article reviews the protean manifestations of CPPD crystal deposition disease with emphasis on diagnostic imaging.
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PMID:Calcium pyrophosphate dihydrate crystal deposition disease. 1459 59

Simultaneous, bilateral, and spontaneous rupture of the quadriceps tendon is a very rare injury. Individuals with this injury are usually predisposed by chronic renal disease with secondary hyperparathyroidism, gout, diabetes, and lupus erythematosus. Often, primary diagnostic confusion can lead to a delay in treatment. Two cases of a bilateral lesion of the quadriceps tendon, that were treated surgically using the technique of Scuderi, followed by an intense rehabilitation programme, are presented. Surgical treatment yields satisfactory results.
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PMID:[Bilateral rupture of the quadriceps tendon]. 1536 34

Massive periarticular calcinosis of the soft tissues is a unique but not rare radiographic finding. On the contrary, tumoral calcinosis is a rare familial disease. Unfortunately, the term tumoral calcinosis has been liberally and imprecisely used to describe any massive collection of periarticular calcification, although this term actually refers to a hereditary condition associated with massive periarticular calcification. The inconsistent use of this term has created confusion throughout the literature. More important, if the radiologist is unfamiliar with tumoral calcinosis or disease processes that mimic this condition, then diagnosis could be impeded, treatment could be delayed, and undue alarm could be raised, possibly leading to unwarranted surgical procedures. The soft-tissue lesions of tumoral calcinosis are typically lobulated, well-demarcated calcifications that are most often distributed along the extensor surfaces of large joints. There are many conditions with similar appearances, including the calcinosis of chronic renal failure, calcinosis universalis, calcinosis circumscripta, calcific tendonitis, synovial osteochondromatosis, synovial sarcoma, osteosarcoma, myositis ossificans, tophaceous gout, and calcific myonecrosis. The radiologist plays a critical role in avoiding unnecessary invasive procedures and in guiding the selection of appropriate tests that can result in a conclusive diagnosis of tumoral calcinosis.
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PMID:Tumoral calcinosis: pearls, polemics, and alternative possibilities. 1670 60

Rheumatoid nodulosis is an entity that describes a particular variant of polyarthritis associated with early manifestations of palindromic rheumatism, radiologic subchondral bone cysts, and subcutaneous rheumatoid nodules. This study describes the clinical, radiologic, histologic, crystallographic, and laboratory findings, as well as the outcome in a group of 16 patients with rheumatoid nodulosis that were followed for a period of 1-12 years. Six of these patients had an aggressive course and developed classic erosive polyarticular rheumatoid arthritis, while the others continued having episodic arthritis without erosive disease. Seven patients had cholesterol crystals in olecranon bursae containing nodules. Second-line drugs used to control the articular manifestations did not improve the nodulosis, erosive, or cystic subchondral bone changes. Rheumatoid nodulosis mimics several other rheumatic diseases, and in about 40%, classic erosive rheumatoid arthritis develops. The presence of cholesterol crystals in rheumatoid nodules or affected bursae can increase the confusion with other crystal-induced arthritis, in particular, tophaceous monosodium urate gout or xanthomatosis.
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PMID:Rheumatoid nodulosis: is it a different subset of rheumatoid arthritis? 1704 77

The majority of patients with gout are cared for by primary care physicians. Although both the physician and patient may easily recognize the acute arthritis of gout, errors in selecting the most appropriate medication and proper dose are common. The clinical stages of gout include asymptomatic hyperuricemia, intermittent gouty arthritis, and chronic tophaceous gout. Treatment of gout is usually considered after the first attack of arthritis, typically podagra. The aims of treatment are to alleviate the pain and inflammation associated with acute attacks, prevent future attacks, and decrease uric acid levels. Confusion frequently arises because certain medications such as colchicine may have dual purposes: to treat an acute attack and to suppress future attacks. The purpose of this management update is to provide practical advice about prescribing the proper medication considering both treatment goals and patient comorbidities.
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PMID:Updates in the management of gout. 1797 6

The name of Sir Alfred Baring Garrod is linked with the first detection of uric acid in blood and its accumulation in sufferers from gout as well as the formulation of the term rheumatoid arthritis. The disease concept formulated by him initially (especially in Germany) caused confusion and much discussion but has now become accepted worldwide. Garrod's work on gout delivered important contributions to the elucidation of pathophysiological problems of the symptoms. Furthermore, he made a great contribution to the reorganization of the British Pharmacopoeia. One of his sons, the also knighted Sir Archibald Edward Garrod, initially continued the work of his father in the field of rheumatology and thereby made it really known. Later he developed his own research field with the establishment of the genetics of metabolism and introduced here the term inborn errors of metabolism.
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PMID:[The High Priest of gout - Sir Alfred Baring Garrod (1819-1907)]. 1993 40


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