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Query: UMLS:C0018099 (
gout
)
5,192
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Serum triglyceride levels are significantly higher and serum high-density lipoprotein cholesterol levels are lower in patients with
gout
compared with healthy individuals. Whereas increased serum triglyceride levels exist intrinsically in
gout
, serum uric acid concentration correlates inversely with insulin sensitivity and positively with serum triglycerides. Interaction of monosodium urate crystals with granulocyte-macrophage colony-stimulating factor and with tumor necrosis factor-activated neutrophils favored the production of interleukin-1 over that of interleukin-1-Ra, resulting in a proinflammatory imbalance. Interaction of the crystals with iron or tyrosine kinase may modify their inflammatory response and can be an important modulating mechanism in gouty arthritis. E-selectin is a specific marker for synovial fluid soluble endothelial activity and is increased in the synovial fluid of patients with gouty arthritis, as well as in that of patients with other inflammatory arthritides. Similarly, E-selectin was found to be high in joints with monosodium urate crystal-induced
synovitis
. In addition, synovial fluid levels of interleukin-8 were found to be high in
gout
, rheumatoid arthritis, and osteoarthritis.
...
PMID:Gout, uric acid metabolism, and crystal-induced inflammation. 754 16
Granulomatous inflammation in a tissue specimen raises concern about infection with Mycobacterium tuberculosis, atypical mycobacteria, certain fungi, Brucella species, and other infectious agents. Inflammatory disorders, such as sarcoidosis, crystal-associated arthritis, or foreign body reactions also are considered when granulomatous changes are seen on histological examination of a tissue specimen. We describe two cases of granulomatous tenosynovitis due to tophaceous deposits in patients with
gout
. In one case, tuberculous
synovitis
was considered the primary diagnosis until the diagnosis of
gout
was confirmed by examination of a tissue specimen with polarized light. In the second case,
gout
and tuberculosis were found in the patient's wrist joint. After antituberculous therapy was discontinued, he continued to have wrist
synovitis
and chronic drainage due to granulomatous tophaceous
gout
. The findings in this report suggest that gouty tenosynovitis can mimic tuberculous tenosynovitis and that
gout
should be considered in the differential diagnosis of granulomatous tenosynovitis, especially when acid-fast stains and cultures are negative for mycobacteria.
...
PMID:Granulomatous tophaceous gout mimicking tuberculous tenosynovitis: report of two cases. 757 37
The ankle is a typical synovial joint. It is affected by systemic as well as locally limited synovial processes. Looking at oligo- and polyarticular diseases it is affected by Reiter's Syndrome and Rheumatoid Arthritis in young patients. In middle aged people Crystal
Synovitides
dominate the picture and in old age
Gout
and tumorous lesions are seen. Looking at monarticular inflammatory processes one has to think of tuberculosis first. Crystal-induced monarthropathies such as hemochromatosis can also start at the ankle. In this review we describe the possible inflammatory diseases of the talocrural joint and present a diagnostic algorithm.
...
PMID:[Synovial lesions of the upper ankle joint]. 767 20
Six of seven patients with Lyme arthritis were positive by PCR. In contrast, all 18 synovial fluid samples from patients with other disorders, including rheumatoid arthritis, spondyloarthropathy,
gout
, pseudogout, hemarthrosis, degenerative joint disease, lupus, papillary
synovitis
, and trauma, were negative by PCR (P < 0.001, Lyme arthritis compared with controls, Fisher exact test). All 38 laboratory controls were negative by PCR. The assay reproducibly detected 20 or fewer B. burgdorferi cells directly or when added to extracted synovial fluid that was previously negative by PCR. Polymerase chain reaction was done four times with identical results, including analyses with both outer surface protein A primer sets.
...
PMID:The persistence of spirochetal nucleic acids in active Lyme arthritis. 831 77
Chondrocalcinosis is a really frequent clinicopathologic entity, which is caused by the penetration of calcium pyrophosphate dihydrate microcrystals into the structures of the joint, including hyaline cartilages and fibrocartilages--hense its name--as well as the synovial fluid and membrane. Calcium
gout
, which preferentially appears in the knees, is the most spectacular and characteristic symptom of chondrocalcinosis, expressing a crisis of acute microcrystal
synovitis
, of which it has all the usual clinical features, and thus simulating uratic
gout
. The positive diagnosis is based on: a) the radiologic demonstration of articular calcifications in the lining cartilages, forming a continuous or fragmented opaque border on the subchondral bone, from which it is separated by a light space, and/or in the fibrocartilaginous structures (most often the menisci, the symphysis pubis, the disk of the inferior radioulnar joint) where they appear as small, irregular clusters with blurred or cloudy margins. The knee is the most frequent site of calcium impregnation images, both in hyaline cartilages and in fibrocartilages. b) the presence of calcium pyrophosphate microcrystals in the synovial fluid; their nature is usually demonstrated convincingly enough with a conventional light microscope; c) needle biopsy findings of microcrystalline clusters embedded in the synovial membrane, that can be easily identified with routine staining. In practice, demonstrating radiologic signs, when these are characteristic and can be detected in their preferred sites, allows recognizing diffuse chondrocalcinosis in satisfactory safety conditions after a calcium
gout
crisis, as well as in the presence of the many atypical or misleading symptomatic aspects of this microcystal arthropathy, that will be the subject of a further paper.
...
PMID:[Role of radiology in the diagnosis of joint chondrocalcinosis. Calcium pseudogout]. 828 7
Hip
synovitis
plays a part in many rheumatic diseases. In the young adult acute arthritis may be due to reaction to trauma, infection or
gout
. Although transient
synovitis
of the hip is a well-known phenomena in children the condition is not well-documented in adults. We present 10 young adults with idiopathic transient
synovitis
of hip who had attended the Soroka Medical Centre between 1986 and 1990.
...
PMID:Benign synovitis of the hip in adults. 836 94
Many musculoskeletal complaints are accompanied by classic signs and symptoms that can be readily diagnosed by the primary care physician. Others are much less obvious and present a diagnostic challenge. In the office evaluation of patients with musculoskeletal complaints, the history is the most informative element. Least helpful are laboratory tests. Although erythrocyte sedimentation rate (ESR), rheumatoid factor, and other widely available tests are sensitive to the presence of rheumatic diseases, they are not specific for any of them. In the initial office evaluation, helpful points of differentiation include the number of joints involved, their location, and, when multiple joints are involved, whether they are symmetric or asymmetric. An acute monarthritis is associated mainly with trauma, infection, or a crystal-induced
synovitis
such as
gout
or pseudogout. Patients with polyarthritis may have symptoms that come and go very quickly, sometimes in < 24-36 hours. This migratory pattern characterizes diseases such as gonococcal arthritis, viral disease, and sarcoidosis. "Rheumatoid variants" such as Reiter's syndrome, psoriatic arthritis, and spondylitis may affect no more than a few joints and are accompanied by other signs, such as nail and skin lesions (psoriasis) or urogenital and enteric infections (Reiter's). Like erosive osteoarthritis, the rheumatoid variants may also cause swelling and inflammation of the distal interphalangeal joints. The classic example of symmetric joint disease is rheumatoid arthritis (RA). While RA often occurs in a progressive and additive pattern, its onset may be followed by a remission several months later. Patients who present with the "algias" may have no physical signs but manifest extensive musculoskeletal pain. Fibromyalgia occurs typically in younger women; polymyalgia rheumatica rarely occurs in patients < 50 years of age and is usually accompanied by a strikingly high ESR. Age and gender should be noted in the office evaluation because they can provide clues not only to these "algias," but other rheumatic diseases seen more frequently in one age or gender group than another.
...
PMID:Office evaluation of the patient with musculoskeletal complaints. 921 53
A comparative study of
synovitis
in Saudi Arabia and Malaysia was made with a view to determining any geographic variation in the incidence and pattern of the arthritides. The diagnostic spectrum in both series included pyogenic arthritis, rheumatoid arthritis, brucellar and tubercular arthritis,
gout
, pigmented villonodular synovitis, synovial chondromatosis and acute rheumatic fever. Date-palm thorn
synovitis
was observed only in the Saudi Arabian series. While brucellar and tuberculous arthritis were predominantly seen in Saudi Arabia, the incidence of rheumatoid arthritis, pigmented villonodular synovitis and acute suppurative arthritis was almost equal in both countries.
...
PMID:Synovial biopsy. A comparative study from Saudi Arabia and Malaysia. 972 15
We report a 56-year-old Japanese male with a
gout
-like acute attack of
synovitis
and panniculitis in his right wrist without hyperuricemia. Calcium pyrophosphate dihydrate (CPPD) crystals were found in the synovial fluid of the affected joint. A diagnosis of pseudogout was made. The attack subsided two days after medication with 30 mg of predonisolon. Although this is a relatively common disease in elderly people, we rarely encounter such case reports in dermatological journals.
...
PMID:A case of pseudogout. 1082 96
Adult hip pathologies are mainly represented by the degenerative disease, so called "osteoarthrosis, or more precisely coxarthrosis". The means of imaging are exposed, according to their specific value: X Rays (measurement of the characteristic angles of the adult hip), Arthrography, CT Scanner, Arthro-CT Scanner, MRI, Bone Scintigraphy, Ultrasonography. Clinical findings differentiate a mechanical syndrome and an inflammatory syndrome. The coxarthrosis is the most frequent, under two forms: primary (idiopathic) coxarthrosis and secondary coxarthrosis. Primary (idiopathic) coxarthrosis has a localised narrowing of the joint space, osteophyte formation, subchondral sclerosis, cyst formation. The destruction progresses slowly, in 10 to 15 years leading to a complete destruction. Bilaterality is frequent. it is treated with total hip prosthesis. There is a rapid form (1 to 2 years) (Postel's Disease). Secondary coxarthrosis occurs after architectural vice, chondral diseases, lack of balance between the size of the head and the acetabulum as in the case of previous fracture or dislocation, avascular bone necrosis of the head of the femur, Paget's disease. Calcium pyrophosphate Deposition disease (CPPD) involves mostly aged women, and also leads to cox-arthrosis. Avascular bone necrosis of the head of the femur involves young adults. Bilateral involvement are frequent. MRI is the most sensitive and the most specific means of early diagnosis, The area of bone necrosis appears as well defined modifications of the upper head of the femur, precisely surrounded by a low signal intensity line on both Ti and T2 weighted imaging. MRI shows articular effusion, bone marrow edema. Scintigraphy gives early findings which are a characteristic, but non specific, hot spot. CT scanner is used for hip destruction evaluation. o Algodystrophy: transient osteoporosis of the hip has a cyclic course, lasting 3 to 9 months. MRI shows an inflammatory pattern in the area of the process(dark in Ti and white in T2, with positive Gadolinium response). Scintigraphy is positive. Staphylococcus location in the hip can be acute or chronic. MRI shows joint effusion, cystic formation and subchondral non specific modifications. Tuberculosis of the hip joint is relatively rare. Greater trochanteric tuberculous involvement is possible under special contexts. Chronic Inflammatory diseases are represented by Rheumatoid Arthritis, Spondylarthritis and other chronic inflammatory diseases. Synovial tumors such as Pigmented Villo Nodular
Synovitis
, Primary Osteochondromatosis, synovial sarcoma have special presentations. The subchondral bone can be involved by amorphous depositions such as in tophaceous
gout
, different varieties of lipidosis, amyloidosis, reticulo histiocytosis. Pen arthropathies are enthesopathies in the anterior rectus tendon, calcifying tendonitis (not to be confused with calcifying soft tissue tumor/chondrosarcoma). The pelvis bone and the femur are involved by primary and secondary tumors or by insufficiency fractures which can mislead to hip pathologies.
...
PMID:[Imaging of chronic hip pain in adults]. 1093 Aug 82
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