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

Two cases of coexistent gout and septic arthritis are presented. The known increased incidence of joint injections in patients with rheumatoid arthritis is contrasted with the relative rarity of this complication in persons with gouty arthritis. The reason for this dichotomy is not clear but it is suggested that an important factor may be the more episodic nature of the gouty process. For patients presenting with acute arthritis the possible concurrence of sepsis and gout should be considered.
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PMID:Coexistent gout and septic arthritis: a report of two cases and literature review. 390 98

This report describes six elderly patients with previously undiagnosed and untreated chronic polyarticular gout, five of whom were seen at a Geriatric Rehabilitation and Assessment Unit within a 3-month period. All were on long-term diuretic therapy. Four patients had coexisting osteoarthritis. Three patients were unable to recall any prior history of attacks of acute arthritis and four patients were significantly disabled from gout. Chronic polyarticular gout in these patients was previously misdiagnosed and inadequately treated, resulting in otherwise preventable disability.
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PMID:Chronic polyarticular gout in the elderly: a report of six cases. 395 33

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

A patient with acute polyarthritis due to crystal-positive simultaneous gout and pseudogout affecting different joints is described. The case emphasises the importance of aspirating more than one involved joint and carefully searching for crystals in patients with acute arthritis involving 2 or more joints, particular those in whom the diagnosis of multiple crystalline joint disease is considered.
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PMID:Multiple-crystal acute polyarthritis. 684 69

Gout can be considered to be a group of diseases that are typified by acute arthritis, tophi and kidney stones. The acute attacks of arthritis should be treated with standard anti-inflammatory agents and the patient should receive maintenance therapy after the second acute attack. The dangers of asymptomatic hyperuricaemia are acute arthritis and uric acid kidney stones. Patients should be treated when the serum uric acid level is greater than 0,54 mmol/l or if the urinary uric acid excretion is greater than 4,2 mmol/l/24 h.
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PMID:[Principles of treatment of gout and hyperuricemia]. 705 9

Chondrocalcinosis is an arthropathy caused by deposits of calcium pyrophosphate-dihydrate microcrystals (CPPD) in the joints and occasionally in the tendons and ligaments. In our region it is almost always seen in its sporadic form in elderly subjects. The patients can be without symptoms or present four different clinical entities: an acute arthritis which can resemble and even be mistaken for an attack of gout or a septic arthritis; an inflammatory polyarthritis suggesting a rheumatoid arthritis; most frequently it appears as a benign polyarthrosis; sometimes it runs a destructive course capable of seriously damaging one or several joints. In certain cases chondrocalcinosis is associated with another metabolic disease. Familial forms have been described in some countries. Factors which induce the formation of the deposits of CPPD in the articular cartilages, fibrocartilages, the synovium and occasionally in the tendons and ligaments remain obscure. In contrast to urate gout, chondrocalcinosis appears to be due to a disturbance of pyrophosphate metabolism localized almost exclusively in the articular region. Its association with polyarthrosis rather frequently leads to destructive arthropathies. No etiological treatment for chondrocalcinosis exists at the present time. Therapy is limited to the administration of nonsteroidal antiinflammatory drugs and physiotherapy.
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PMID:[Chondrocalcinosis]. 711 58

In an open clinical study the efficacy and tolerability of [1-(p-chlorobenzoyl)-5-methoxy-2-methylindole-3-acetoxy] acetic acid (acemetacin, TV 1322, Rantudil) were studied in 15 patients (2 female and 13 male) suffering from acute arthritis urica. Basing on the heterogeneity of the patients it was possible to estimate the minimal dose of acemetacin necessary to treat slight, moderately severe and extremely severe forms of the complaint. With the exception of one patient who suffered from an extremely severe attack of gout, all patients were completely free from pain within 7 days of therapy. The same results were also valid for the parameters reddening, swelling and functional and impairment. In 12 of 15 cases the assessment of therapy was given as "good" by the patients as well as the physicians. In only one instance was it necessary to give colchizin concomitantly to ensure that the patient was free from pain. In this case, the gout, had over many years, assumed a chronic character and during acute attacks manifested to an almost generalised arthritis. Despite the relatively high daily doses--in some cases up to 600 mg/day--only one case of slight gastric disorder was recorded as an undesired side effect. This, however, did not necessitate withdrawing the drug. It can thus be concluded that acemetacin in the doses used in this study is effective in the therapy of acute gout and is well tolerated at relatively high daily doses.
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PMID:[Therapy of acute attacks of gout using acemetacin (author's transl)]. 719 17

To investigate the occurrence of acute arthritis after stroke, we prospectively studied 111 patients presenting with their first stroke and no history of previous arthritis. Clinical, biochemical and serological assessment was complemented by brain CT scan; appropriate X-rays were taken of any inflamed joints and synovial fluid was collected and analysed. Those with aseptic arthritis were randomly chosen to receive either intra-articular steroids or non-steroidal anti-inflammatory drugs (NSAIDs). Patients with significant renal impairment were excluded. Acute arthritis was observed within 8.34 (median) days, on the paretic side in 19 patients (10 crystal, 4 inflammatory osteoarthritis, 1 septic, 4 unexplained) and on the non-paretic side in 4 patients (1 inflammatory osteoarthritis, 1 septic, 2 unexplained). One patient had pseudogout affecting both sides. Thiazide therapy prior to the stroke was associated with gout in 3 patients. Hospital patients with arthritis had a longer median length of stay than those without (41 vs. 21 days: p = 0.01). Patients receiving intra-articular steroids recovered more rapidly than those treated with NSAIDs (p < 0.05). This prospective study demonstrates the occurrence of acute arthritis in paretic limbs after stroke. Physicians should be aware of this complication, and that administration of intra-articular steroids in aseptic cases speeds rehabilitation and recovery.
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PMID:The incidence of acute arthritis in stroke patients, and its impact on rehabilitation. 810 38

Articular chondrocalcinosis is identified by radiological opacity of articular cartilage and fibrocartilage with calcium intensity. This disease is often asymptomatic. The most significant clinical pattern is an acute arthritis, caused by microcrystals of calcium pyrophosphate dihydrate, the so-called pseudo-gout syndrome. Chronic pyrophosphate arthropathy can blend mechanical illness and inflammatory flares. When the X-rays are normal or display ordinary osteoarthritis, arthrocentesis makes the diagnosis thanks to the identification of calcium pyrophosphate crystals by polarizing microscope. Large joints are usually involved but the disease can impair the spine, small joints, tendon sheaths or synovial bursae. Though unpredictable the evolution can be worse than that of common osteoarthritis and strike joints that are usually spared by primary arthrosis. One can even see articular destruction. Thus certain patients may resemble rheumatoid arthritis, others a Charcot joint. The disease does not exist in children. Its outcome before the age of fifty implies the search for familial occurrence or a secondary form (hyperparathyroidism, hypophosphatasia, hemochromatosis, hypomagnesemia). The sporadic, primary chondrocalcinosis is very frequent in old age.
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PMID:[Clinical manifestations of joint chondrocalcinosis]. 817 72

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.
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PMID:Benign synovitis of the hip in adults. 836 94


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