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)

Popliteal cysts which rupture to mimic a deep vein thrombosis (DTV) can be seen in rheumatoid arthritis and other inflammatory arthritides. Gout with cystal synovitis and ruptured popliteal cyst has only been sporadically reported and nowhere has this occurred more than once.
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PMID:Recurrent rupture of a popliteal cyst in a patient with chronic tophaceous gout. 321 67

Fibronectin was shown to bind heat-aggregated, but not monomeric, human IgG, suggesting that fibronectin may bind directly to IgG immune complexes. The presence of material both binding and already containing fibronectin was demonstrated in polyethylene glycol precipitates of sera and synovial fluids from patients with rheumatoid arthritis (RA) and gout, but not normal sera. By contrast, complement-fixing complexes contained fibronectin in RA synovial fluids and sera, but not in sera and synovial fluids from other rheumatic disorders. It is considered that fibronectin binds to immune complexes in RA synovial fluids and sera but that some other, as yet unidentified material, is effective in binding fibronectin in sera and synovial fluids from patients with osteoarthritis and crystal synovitis.
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PMID:Fibronectin binding with immunoglobulin aggregates and its association with rheumatic disorders. 349 Aug 95

Recently, calcium oxalate crystals have been identified in the synovial fluid of patients with arthritis and end-stage renal failure. We describe 4 patients who, during the course of long-term hemodialysis, developed calcium oxalate crystal deposits in the synovium and skin. Clinical manifestations included podagra, tenosynovitis, olecranon bursitis, and acute and chronic synovitis of the large joints that were associated with chondrocalcinosis or subchondral bone erosions. Diffuse involvement of the hand, with chondrocalcinosis of the finger joints, miliary calcified deposits in the skin, and artery calcifications, was observed in 3 patients. The fourth patient had erosive arthropathy. Oxalosis secondary to end-stage renal failure in patients treated with long-term hemodialysis can present with articular manifestations that resemble those of gout, pseudogout, and apatite deposition disease. Other characteristic features of the synovitis associated with oxalosis secondary to end-stage renal disease were: predominant involvement of the hand, mild inflammatory changes in the synovial fluid and synovium, and poor response to administration of nonsteroidal antiinflammatory agents.
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PMID:Arthropathy and cutaneous calcinosis in hemodialysis oxalosis. 377 44

Recent studies have confirmed that gout is an inborn error of metabolism. It has now become evident that the hyperuricemia associated with gout might occur either due to overproduction of uric acid, underexcretion of uric acid or a combination of these processes. Furthermore, patients with excessive purine synthesis may have a specific enzyme defect resulting in altered feedback inhibition of purine synthesis. A neurological disease manifest by mental retardation, choreo-athetosis, aggressive behavior, lip-biting and self-mutilation and associated with decidedly increased purine biosynthesis serves as a prototype of this kind of disorder. Other defects in regulation of purine biosynthesis have been postulated but their existence not yet confirmed. It has been demonstrated that urate crystals which are deposited from hyperuricemic body fluids set up an acute inflammatory reaction by means of a variety of chemical mediators. Thus, acute gouty arthritis is now recognized as an example of "crystal induced" synovitis. The treatment of gout consists of (1) the control of acute gouty attacks, and (2) the maintenance of normal serum uric acid concentrations. This latter may be achieved either with uricosuric drugs or with xanthine oxidase inhibition. With these principles in mind, it is now possible to avoid many of the severe crippling effects of gout and to restore the vast majority of gouty patients to useful and productive lives.
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PMID:Current concepts of hyperuricemia and gout. 577 83

105 consecutive patients who presented to a rheumatologist because of joint disease and who also had evidence of deposition of calcium pyrophosphate dihydrate (CPD) were studied clinically and radiologically. There were 76 women (mean age 73) and 29 men (mean age 62). Of only 18 patients below the age of 60 at presentation 12 were men. The majority of the younger male group suffered from acute attacks of synovitis, and had no clinical or radiological evidence of joint damage. In contrast the older female group had widespread destructive changes. Associated joint disease included generalised osteoarthritis (45), rheumatoid arthritis (8), joint hypermobility (13), previous knee surgery (8), and gout 92). Sixteen patients had received long-term steroid therapy. Severe destructive joint changes were seen in 16 patients. The radiological features in those with rheumatoid arthritis by ARA criteria were atypical. The relationship between CPD deposition and arthritis is discussed in the light of these findings.
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PMID:Pyrophosphate arthropathy: a clinical and radiological study of 105 cases. 711 20

174 knee joints with non-traumatic effusion have been examined by arthroscopy. In 71 cases synovial biopsy was performed. 43% of the knees had cartilaginous damage of the patella or tibiofemoral joint, 19% had an old meniscal and/or ligamentous tear and 33% a "non-specific" synovitis. The remaining 5% comprise 5 patients with pigmented villonodular synovitis, 3 patients with gout, one with synovial tuberculosis and one with a hemangioma of synovial membrane. Arthroscopy serves for early recognition of degeneration of hyalin cartilage and meniscal lesions, while synovial biopsies are also largely non-traumatic. Endoscopic evaluation of synovial membrane is more difficult. Mechanical irritation produces proliferation of synovial villi, while bacterial and rheumatoid inflammation leads to exudative and necrotic changes. The differences are obvious in marked inflammation but difficult to recognize in the beginning of any process. Arthroscopic and histological examination determines the etiology of synovitis only in pigmented villonodular synovitis and synovial tuberculosis. In the other forms of synovitis it is only possible to determine the stage and intensity of inflammation but not the etiology. The diagnosis of rheumatoid arthritis in particular is seldom secured by arthroscopy.
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PMID:[Results of arthroscope studies of knee joint effusions of unknown origin]. 714 53

Use of the flexible-hinge, double-stemmed implant has eliminated many of the complications that followed correction of an arthritic first metatarsophalangeal joint caused by hallux valgus. There were no reports in the literature of acute gout after this type of correction. The authors present such a case in a patient with a history of gout, and they suggest that, when a synovectomy is performed in a patient with gouty arthritis, the joint should be freed of synovial tissue in which a uric acid crystal-induced synovitis could occur.
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PMID:Acute gouty arthritis in a first metatarsophalangeal joint replaced with a flexible-hinge implant: a case report. 727 57

The coexistence of chronic tophaceous gout and rheumatoid arthritis (RA) in the same patient is extremely rare. Only 6 cases, considered genuine, including ours, have been reported. With 1 exception, all the reported cases, including our own, were males and gout was the initial disease followed years later by the development of RA. We are proposing modified criteria for the definite diagnosis of RA and gout in the same patient to avoid the inclusion of many patients with chronic topaceous gout, who would otherwise fulfill the American Rheumatism Association criteria for RA. We stress the importance of fixation of biopsy material in formalin and alcohol to avoid diagnostic errors, since granuloma with histologic features resembling a rheumatoid nodule or rheumatoid synovitis may show the presence of crystals of monosodium urate when examined with compensated polarized light microscopy.
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PMID:Coexistence of chronic tophaceous gout and rheumatoid arthritis. 732 73

An association between urate gout and chondrocalcinosis has been suggested in several studies, but the situation remains ill-defined because of lack of appropriate controls, small numbers of patients studied, or retrospective investigation. An association has also been claimed between gout and avascular necrosis of the femoral head. 138 patients with gout and 142 non-gouty control subjects were carefully matched for age and x-rays were taken of the knees and pelvis. Chondrocalcinosis of the knees was detected in 8 patients with gout (5.8%), no cases being found in the control group. The difference is significant (P less than 0.025). Deposits were linear or irregular. Six of the 8 patients gave a history of acute synovitis of the knees; fluid had been aspirated in 2 of them, urate crystals being found in one and no crystals in the other. Six of 8 patients showed evidence of chondrocalcinosis elsewhere. No association was apparent between chondrocalcinosis and the presence of tophaceous deposits or renal impairment, though the duration of gout appeared to be longer in the patients with chondrocalcinosis than in the other gout patients and osteoarthrosis of the knees commoner. There was no evidence of other metabolic disorders commonly associated with chondrocalcinosis. No cases of avascular necrosis of the femoral head were found.
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PMID:Frequency of chondrocalcinosis of the knees and avascular necrosis of the femoral heads in gout: a controlled study. 737 63

Association of two tunnel syndromes secondary to tophaceous gout is uncommon. This article presents a case of ulnar and carpal tunnel compression. It concerns a 71 year old man with gout and treated for that condition. He presented with paraesthesiae in the fingers and loss of muscular strength in right hand. Physical examination discovered two masses, one in the epitrochlear groove, the other in the olecranon bursa; a severe ulnar palsy and a carpal tunnel syndrome. Neurolysis of both ulnar and median nerves was performed. After 2 years follow-up, paraesthesiae disappeared but atrophy of ulnar intrinsic muscles remained unchanged. The literature is reviewed. Carpal tunnel syndrome is well known in gout (28 reported cases), and is secondary to gouty tenosynovitis. Ulnar tunnel syndrome has been described once by Akizuki in 1984. The combination of the two conditions has not been previously been reported. In our case, median nerve compression was secondary to gouty synovitis but also to a bulky tophus from the floor of the carpal tunnel.
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PMID:[Double tunnel syndrome of the upper limb in tophaceous gout. Apropos of a case]. 751 10


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