Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Degenerative arthritis in the aged includes two major disease categories--osteoarthritis and the crystal-associated arthropathics. The crystals chiefly involved are monosodium urate (gout) and calcium pyrophosphate dihydrate (CPPD), although several others (e.g., cholesterol, brushite and apatite) have been implicated. This report illustrates how the newer diagnostic techniques such as polarized-light microscopy, analytical electron microscopy and x-ray microdiffraction have augmented knowledge concerning diseases associated with articular crystal deposition. For example, diffraction techniques are required for accurate identification of the apatite crystals found in synovial fluid effusions and in the matrix vesicles of degenerate cartilage. According to ultrastructural studies, monosodium urate crystals found in tophi, joint surfaces and effusions show a distinct morphology. Present in inactive joints, the crystal surfaces are bare; in acute gout, the crystals are covered with mucin, confirming the observation that protein binding to crystals is necessary for inflammation to proceed. CPPD disease is by far the most common crystal-associated arthropathy affeting the aged. The incidence of CPPD deposits in articular tissues increases with age but, in contrast to gout, affects both men and women. The pathogenesis of CPPD disease is a mystery, but factors under investigation include matrix abnormalities, ionic imbalances, and enzyme disorders.
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PMID:Crystal-associated arthropathies: what's new in old joints. 625 59

The inflammatory activity of joints can be stated after intravenous administration of 99mTc-pertechnetate by demonstration of an enrichment of isotope. In 85 out of 111 patients (77%) a good accordance between profilogram and clinical finding could be seen. "False positive" results could be found in juvenile rheumatoid arthritis, ulcerative colitis, reactive arthritis and juvenile gout. In some cases of juvenile rheumatoid arthritis the clinical finding is later obvious than the demonstration by nuclear medicine. "False negative" results mainly can be seen at the wrists of patients with juvenile rheumatoid arthritis and tendosynovitis as well as in already existing radiological changes of the bones. Differential diagnostical evidences of profilography cannot be expected with the investigation technique used here. It, however, may contribute to assure the diagnosis in non-inflammatory joint diseases ("psychogenic rheumatism", lymphatic oedema).
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PMID:[Profilographic studies with 99mTc-pertechnetate in joint diseases in children]. 626 26

The identification of monosodium urate crystals in joint effusions of patients with gouty arthritis established that crystals can cause arthritis. Other crystals causing arthritis have also been identified, including calcium, pyrophosphate dihydrate (chondrocalcinosis, pseudo-gout), calcium hydroxapatite crystals (calcific periarthritis, acute arthritis) and depot corticosteroid crystals (which occasionally cause arthritis when injected intra-articularly.) Crystal-induced arthritis is characterized by acute articular inflammation although rarely causing joint destruction or permanent disability. It is important for clinicians because it can mimic more serious joint diseases like septic arthritis or even rheumatoid arthritis. It can be diagnosed with precision and in some types as in gout can be treated effectively. Also, it constitutes one of the best understood articular inflammatory processes and often is the first clinical clue for the presence of curable metabolic or endocrine diseases.
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PMID:Crystal-induced arthritis. 628 63

In William Harvey's day almost any or every arthropathy was termed gout. This is evident in the case histories of some of his patients and in his own case, where his own cold water therapy would suggest the correct diagnosis was not gout but erythromelalgia (Weir Mitchell's disease).
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PMID:William Harvey and his gout. 637 Jan 46

The amount of the initiating complement component (Clq) in the classical pathway and the first essential component (C3) in the alternative complement pathway were measured with a single radial immunodiffusion (SRID). A high ionic strength was used corresponding to that of 0 . 25 M NaCl and 0 . 01 M EDTA to avoid nonspecific binding of Clq with immune aggregates. Measurements were made on sera and/or synovial fluids from 165 patients with various bone and joint diseases. Values of Clq and C3 in synovial fluids were also expressed as ratios to that of albumin in the same specimens to avoid the influence of differences in volume of synovial fluid in various diseases, and this appeared to provide a reliable index reflecting pathological conditions. Both serum Clq and C3 levels were raised highly in rheumatoid arthritis, gout, and osteomyelitis, but the extent of the elevation of C3 was less conspicuous. Values of Clq and C3 in synovial fluids also markedly increased in rheumatoid arthritis.
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PMID:Immunochemical quantitation of complement components of Clq and C3 in sera and synovial fluids of patients with bone and joint diseases. 677 72

In the pathogenesis of painful dysfunctions of the locomotor apparatus superficial pain, deep pain and compression pain as well as referred pain play a role. The development of this pain is discussed. The differential diagnosis of radicular and pseudoradicular forms of pain of the vertebral column is discussed. The most clinical important rheumatic pain syndromes, myalgia, arthritis and arthrosis as well as the development of pain in gout attacks are described according to the natural history and clinical presentation of the disease. Therapeutic indications are given. The importance of the differential diagnostic evaluation of pain syndrome is stressed, in particular if it seems, that there is no organic background.
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PMID:[Pathogenesis and clinical features of painful dysfunctions of the locomotor system]. 698 65

Practically 10-20% of all patients registered with a General Practitioner complains of symptoms in some way associated with rheumatism. Incidences of this disorder are distributed in such a way as to form a pattern whereby 55% is troubled with extra-articulary rheumatism, 38% with arthrosis and spondylarthrosis and 7% with rheumatoid arthritis. It is of most importance that the General Practitioner identifies these patients during the early stages of their disorder, and that he commerces the necessary treatment immediately. With the exception of streptococcus-rheumatism and gout, the pathogenesis of rheumatics eludes us to this day. As far as individual measures are concerned therefore, it is merely a question of selecting some kind of treatment, ranging from the symptomatic to the semi-causal, which can be used alongside the recommended form of therapy. The author describes various kinds of treatment including NSTAR, Glucocorticoids, Antisuppressives and basic therapy such as Chloroquin, gold and D-Penicillamin.
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PMID:[Comprehensive review of the possibilities and limits of drug therapy of rheumatic diseases]. 698 70

A practically complete destruction of both femoral heads including the femoral necks and acetabula was encountered in a 69-year-old patient with diabetes, which varied in intensity. This destruction, documented by radiographs which had been taken 8 years prior, had started as the typical picture of "idiopathic femoral head necrosis". In addition to diabetes, hyperuricemia and hyperlipoproteinemia were present at the time when the femoral head necrosis was first evidenced. One episode of gout was recorded. In recent years, following therapy, the hyperurecemia and hyperlipoproteinemia had normalized. The question is raised, as to whether or not the present radiological findings represent a complication of aseptic femoral head necrosis, combined with a diabetic arthropathy of the hip joints. Details of the angiographic findings and a spondylopathy, which have all the characteristics of a neuropathic spondylopathy, would favor this hypothesis. When associated with a diabetic condition, generalized osteoporosis and hypertrophic spondylosis of such a particular nature require special mention.
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PMID:Complete destruction of both femoral heads following idiopathic necrosis of the femoral heads in a diabetic patient with hyperuricemia and hyperlipoproteinemia. 699 Aug 94

A multicentre trial involving 1350 patients evaluated by 310 practitioners throughout South Africa was conducted to determine whether overseas studies relating to the efficacy and toleration of piroxicam (Feldene; Pfizer) would be confirmed in the local environment. Piroxicam, a member of a new class of non-steroidal anti-inflammatory agents, possesses a long plasma half-life permitting a once-a-day dosage regimen in osteo-arthrosis, rheumatoid arthritis, ankylosing spondylitis, acute musculoskeletal disorders and acute gout. In this study it was found to provide significant relief of pain and stiffness and to have a relatively low side-effect profile, confirming that it is a useful addition to current non-steroidal anti-inflammatory drug therapy.
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PMID:An evaluation of piroxicam, a new non-steroidal anti-inflammatory agent. A multicentre trial. 701 42

Arthritis commonly accompanies clinical disturbances of metabolism, while diseases which are primarily articular may cause major general metabolic abnormalities. The relationship between diet, nutrition and joint diseases is complex and varies from simple mechanical factors (as in obesity) to complex metabolic processes. Current knowledge of these processes is extensive in some areas, such as in gout and hyperuricaemia, whereas in others, such as the arthropathy encountered after intestinal bypass surgery, it is very scant indeed. Joint disorders in hyperlipoproteinaemia and diabetes mellitus are varied and the pathogenesis of these articular problems is as yet ill understood. In view of the frequency with which these metabolic problems occur, these disorders offer no opportunities for the clinical study of the processes involved in joint inflammation and damage. In contrast, metabolic abnormalities such as hypergastrinaemia and elevated ionized calcium in rheumatoid arthritis are worthy of study, as they may offer clues to the underlying aetiology of the joint disease. This latter abnormality is suggestive of hyperparathyroidism, a condition which may present with polyarthritis and in which joint changes may be severe, although they are usually obscured by the more obvious bony problems in this disease. An illustrative historical vignette is included.
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PMID:Some metabolic aspects of arthritis. 703 19


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