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)

Of 9,108 consecutive new patients seen in an outpatient rheumatology clinic, 155 (1.7%) were diagnosed as having gout. But 164 (1.8%) had been incorrectly diagnosed as having gout in the community. Misdiagnosis was more likely in those with psoriatic arthritis (odds ratio 3.841, 1.944-7.590) and pseudogout (odds ratio 4.152, 2.422-7.119) and less common in patients with nonspecific arthralgias (odds ratio 0.536, 0.326-0.881). Seventy-six percent of incorrectly diagnosed patients received allopurinol while slightly more than 15% were treated with uricosuric agents.
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PMID:The misdiagnosis of gout and hyperuricemia. 194 30

The basic principles of the determination of crystals in synovial fluid by means of the polarisation microscope are described. The presence of crystals in synovial fluid was determined in 48 patients with the following clinical diagnoses: rheumatoid arthritis, gout, pseudogout, reactive arthritis, in patients with a diagnosis of extraarticular rheumatism: peritendinitis, in patients with reactive arthritis and in 2 patients with injured knee joint. Crystals of Na urate, Ca-pyrophosphate dihydrate and cholesterol were found. The analysis of synovial fluid for the presence of crystals in an important diagnostic procedure contributing greatly to the quick and correct diagnosis of arthritis.
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PMID:[Identification of crystals in synovial fluid]. 196 21

Intrinsic disorders that can cause shoulder pain include arthritis, gout, pseudogout and osteonecrosis. In its mildest form, impingement syndrome may cause only minimal discomfort. At its worst, impingement syndrome may lead to rotator cuff tear. Bicipital tendinitis and rupture of the biceps tendon may also be associated with impingement. Early rehabilitative intervention is important. Physical therapy is directed toward restoring range of motion and muscle strength.
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PMID:The painful shoulder: Part II. Intrinsic disorders and impingement syndrome. 199 Jul 35

A variety of rheumatologic disorders affect the elderly. Some of these problems are seen almost exclusively in the elderly, such as temporal arteritis and pseudogout. Because of underlying chronic diseases, these patients are also at increased risk for joint infection and resultant sepsis. Evaluation of synovial fluid from the inflamed joint is important. Light microscopy evaluation with a red polarizing compensator can help diagnose crystal-mediated disease, such as gout or pseudogout. Examination of Gram stains can help diagnose infectious arthritis. Thus, appropriate processing of synovial fluid is mandatory for the diagnosis of many rheumatologic disorders that occur in the elderly. A variety of metabolic disorders are associated with pseudogout and should be searched for on laboratory evaluation. Appropriate laboratory evaluation and follow-up following the acute episode are important in the care of these patients. For example, temporal arteritis with resultant blindness is a feared disorder in the elderly. Transient blindness, headaches, jaw claudication, and an elevated Westergren sedimentation rate suggest this diagnosis. Aches and pain in the neck and shoulder area, especially in the morning, are typical of polymyalgia rheumatica. Polymyalgia rheumatica may also be a symptom of temporal arteritis.
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PMID:Acute rheumatologic disorders in the elderly. 218 87

Synovial fluid samples (139) from 121 patients with rheumatoid arthritis, osteoarthritis, pseudogout, chronic pyrophosphate arthritis, gout, and reactive arthritis were analysed for cartilage proteoglycan components. Keratan sulphate (KS) epitope was determined by a competitive radioimmunoassay, and total sulphated glycosaminoglycans (S-GAG) were determined after papain digestion by a specific dye binding assay. Increased concentration of both KS epitope and S-GAG were found in synovial fluid from joints with acute inflammatory arthropathy (gout, pseudogout, and reactive arthritis). Analysis of consecutive samples from the same joint at different stages showed that the concentration of KS epitope or total S-GAG varied with acute inflammatory activity. In samples from patients with chronic conditions during active and inactive inflammatory phases concentrations were much lower and not distinguishable among these disease groups. The detection of raised concentration of proteoglycan components may reflect the rapid depletion or greatly increased turnover of proteoglycan in the articular cartilage during acute inflammation in the joint. This did not appear to be sustained in most patients with chronic joint diseases.
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PMID:Increased concentrations of proteoglycan components in the synovial fluids of patients with acute but not chronic joint disease. 246 86

In this work, the authors have pointed out the role of xeroradiography in the diagnostic assessment of joint disorders associated to dystrophic microcalcifications (gout, pseudogout, acute calcific periarthritis). Within this class of pathology, the physical and technical characteristics of xeroradiography imaging (side-effect; showing of details; wide range of x-ray exposition; small density differences) are capable to depict all the joints and related structures involved. In addition particular attention was paid to drew out the joint disorders associated to dystrophic microcalcifications from the vague and non specific term of "arthropathy".
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PMID:[Xerography of diseases caused by microcrystalline deposits]. 253 2

Crystal-related joint diseases are often associated with systemic inflammatory manifestations, including increased levels of acute-phase proteins, leukocytosis, and fever. Recently, interleukin-6 (IL-6) has been identified as a pluripotent mediator of inflammatory and immunologic responses and the major hepatocyte-stimulating factor. In this study, we demonstrated that monosodium urate (MSU) and calcium pyrophosphate dihydrate (CPPD) crystals, and to a lesser extent, hydroxyapatite crystals, increased IL-6 production by synoviocytes and monocytes in vitro. Immunoprecipitation experiments showed that MSU and CPPD crystals, but not hydroxyapatite crystals, were able to increase the release of newly synthesized IL-6. Crystal-induced IL-6 stimulated acute-phase protein synthesis, immunoglobulin production, and hybridoma cell proliferation, which was neutralized by a specific antibody to IL-6. High levels of IL-6 were found in synovial fluid from patients with gout and pseudogout. These results demonstrate that MSU and CPPD crystals can induce IL-6 production in synoviocytes and monocytes, and that synovial fluid from patients with gout and pseudogout contains high levels of IL-6. Crystal-induced IL-6 is likely to be an important mediator of inflammatory responses in acute gout and pseudogout.
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PMID:Inflammatory microcrystals stimulate interleukin-6 production and secretion by human monocytes and synoviocytes. 255 32

The rheumatic manifestations of familial hypercholesterolemia include recurrent Achilles pain or tendinitis, acute mono/oligoarthritis and migratory (rheumatic fever-like) polyarthritis. Diagnosis is made by finding skin and tendon xanthomas, hypercholesterolemia, and ruling out other rheumatic conditions such as rheumatic fever, gout, pseudogout and septic arthritis. A patient, homozygous for familial hypercholesterolemia, with a rheumatic fever-like migratory arthritis is presented.
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PMID:Hypercholesterolemic (type II hyperlipoproteinemic) arthritis. 275 74

Adenosine triphosphate pyrophosphohydrolase (ATPPPH) and neutral inorganic pyrophosphatase activities were assayed in synovial fluids (SF) from 37 patients with a variety of arthropathies. ATPPPH activity was detected in all fluids, but was highest in patients with chronic chondrocalcinosis; its activity in patients with osteoarthritis was higher than that in patients with rheumatoid arthritis, gout, or pseudogout. ATPPPH activity correlated positively with SF pyrophosphate concentration and negatively with SF white blood cell count. Pyrophosphatase activity did not correlate with diagnosis, pyrophosphate level, or white blood cell count.
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PMID:Adenosine triphosphate pyrophosphohydrolase and neutral inorganic pyrophosphatase in pathologic joint fluids. Elevated pyrophosphohydrolase in calcium pyrophosphate dihydrate crystal deposition disease. 299 8

Calcium pyrophosphate dihydrate crystal deposition disease is a clinical condition characterised by Gout-like synovitis (pseudogout), calcification on and around the joints and an arthropathy that is radiologically similar to osteoarthritis (chronic pyrophosphate arthropathy). Though all these radiological clinical aspects may coexist in the same patient this is often not the case. An examination of the X-ray data on the 68 cases studied which were diagnosed on the basis of the criteria proposed by McCarty, shows that the disease is relatively common especially in the over-fifties. When chronic pyrophosphate arthropathy is the only clinical manifestation of the disease differential diagnosis from the osteoarthrosis so common in the elderly is difficult and depends on the greater severity and progression of the joint damage that may often affect joints not subjected to weight such as the shoulder, unlike what happens in osteoarthritis.
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PMID:[Clinico-radiologic aspects of calcium pyrophosphate dihydrate deposition disease]. 302 32


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