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

In five patients with acute arthritis in whom gout was eventually documented, an initial synovial fluid analysis failed to reveal urate crystals. Four of the patients were seen in one hospital during a period of 30 months in which 103 cases of gout were documented on initial aspiration. While this is an uncommon event, the importance of being able to make a definitive diagnosis of gout is such that re-aspiration of the same or other joints may be justified under certain circumstances.
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PMID:Gout without crystals on initial synovial fluid analysis. 63 78

In a general practice survey of gout, an analysis was made of the criteria relating to the diagnosis in 604 patients. Approximately 60% of diagnoses were made within 1 month of the patient presenting with symptoms; in the remainder, there was often a considerable time lag before diagnosis and half of these patients had been wrongly diagnosed initially. Of the total cases, approximately 8% were diagnosed in hospital and only about 20% of cases were referred for diagnosis or subsequent management advice. Most diagnoses were based on the presentation by the patient of a typical acute arthritis, and a raised serum urate level was used as a confirmatory factor. Few patients presented with tophi and response to colchicine was infrequently used in diagnosis, as were diagnostic X-rays or synovial fluid examination for crystals.
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PMID:Diagnosis of gout in general practice. 73 76

The effectiveness of naproxen in the management of acute gouty arthritis was assessed in an open study of 20 patients. These patients were selected on the basis of their clinical presentation of characteristic acute arthritis associated in 19 with concomitant hyperuricemia. There were 17 men and three women varying in age from 35 to 89 years. The first 12 patients were treated with 600 mg naproxen initially, followed by 300 mg every 8 hours for the first 48 hours and then tapered or discontinued depending upon their clinical response. The last eight patients received a loading dose of 750 mg naproxen, followed by 250 mg every 8 hours for a duration of 72 hours before tapering the drug. The response of 15 of the 20 was either excellent or good, while the response was fair in three and poor in two. Poor responders had been failures in other regimens or were treated late in the course of their attack. The higher loading dose was associated with more rapid and satisfactory remission. No significant undesirable side effects were observed. On the basis of this study, naproxen was found effective in alleviating the inflammation of acute gout.
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PMID:The treatment of acute gout with naproxen. 109 30

Gout commonly occurs as an acute arthritis. In a 64-year-old man, gout was associated with a proliferative hemosiderin-laden synovitis. The association of recurrent atraumatic hemarthrosis seems not to have been reported in the literature on gout.
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PMID:Recurrent hemarthrosis associated with gout. 155 50

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

Frequency of gout in French Polynesia has induced us to define a type of "hyperuricemia Polynesian" from a population of patients admitted in a general Medicine Ward. Each admitted patient gets immediately a blood check-up. A figure higher than 70 mg/l in male and 60 mg/l in female is considered as pathological. In such a case, uricemia and uraturia are tested every 24 h for three days and we consider the mean value of these three tests. On the other side, some admitted patients non-hyperuricemic, are examined according to the same protocol. So, we have two groups: 31 hyperuricemics and 20 non-hyperuricemics, secondarily grouped according to age, sex, ethnic. We did not consider some secondary causes of hyperuricemia (chronic renal insufficiency diuretic treatment, psoriasis etc.). 1. Within the hyperuricemic population, mean uricemia is 85.35 mg/l versus 52.65 mg/l in the second sample. In the hyperuricemic group (21 males and 10 females) 48% are gouty and 13% of them are females. Articular manifestations are acute arthritis, affecting mainly inferior limbs, ankles, knees). We did not notice any significant divergence between uricemia and uraturia of gouty and non gouty people. Within the group of gouty people, percentage of individual hyper excretion is 53% (uraturia greater than 600 mg/24 h) with no significant divergence with the non-gouty group: Nephrolithiasis is rare (3%). There is no significant divergence between urinary pH of gouty and non-gouty people. Associated metabolic troubles are: diabetes (26%) high triglyceridemia (43%) three syndromes associated together (hyperuricemia + diabetes + hypertriglyceridemia) in 19.5%, total cholesterol is normal (2.07 g/l) but a low cholesterol (0.30 g/l).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Study of hyperuricemia in Tahiti. 31 cases hospitalized at the Territorial Hospital Center in Papeete (Tahiti)]. 160 55

A patient with coexistent Klinefelter's syndrome, systemic lupus erythematosus (SLE) and chronic tophaceous gouty arthritis developed allopurinol hypersensitivity. The drug was reinstituted by a schedule of gradually increasing doses. Gout should be considered in the differential diagnosis of patients with SLE who present with acute arthritis and/or subcutaneous nodules particularly in those with longstanding stable nephritis who are receiving diuretics for concomitant hypertension.
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PMID:Allopurinol hypersensitivity in a patient with coexistent systemic lupus erythematosus and tophaceous gout. 317 3

We report a case of calcium oxalate arthropathy in a woman undergoing intermittent peritoneal dialysis who was not receiving pharmacologic doses of ascorbic acid. She developed acute arthritis, with calcium oxalate crystals in Heberden's and Bouchard's nodes, a phenomenon previously described in gout. Intermittent peritoneal dialysis may be less efficient than hemodialysis in clearing oxalate, and physicians should now consider calcium oxalate-associated arthritis in patients undergoing peritoneal dialysis who are not receiving large doses of ascorbic acid.
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PMID:Arthritis associated with calcium oxalate crystals in an anephric patient treated with peritoneal dialysis. 340 40

Over a 12-month period, 150 patients were seen at an acute arthritis clinic to assess the type of case not usually seen in our chronic service, where delays of up to 24 weeks may occur before patients can be investigated. The majority of patients in whom the diagnosis could confidently be made had either gout or reactive arthritis, and, while the former diagnosis was unlikely to be missed, many practitioners seemed unaware of the type of presentation and variety of organisms that can cause reactive arthritis. Despite intensive investigation, a diagnosis could not be made in some cases. Those with septic arthritis had a better prognosis than patients in a previous series from this centre. Early referral leading to prompt diagnosis of this serious complication may have been an important factor in the improved outcome.
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PMID:An acute arthritis clinic--one year's experience. 373 Jul 38

The case of a 42-year-old white male with a 7-year history of multiple subcutaneous nodules and intermittent episodes of acute arthritis is presented. The patient was found to have monosodium urate crystals on joint aspiration and rheumatoid nodules on biopsy. Our patient, the first reported case of coexistent rheumatoid nodulosis and gout, emphasizes the importance of a thorough evaluation and the need to account for all available clinical and laboratory data. The classification system, differential diagnosis and clinical manifestations of patients presenting with rheumatoid nodules are briefly reviewed.
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PMID:Coexistence of rheumatoid nodulosis and gout. 377 30


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