Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 33-yr-old male ran 10 miles, drank some beer, and developed pain in his left knee and ankle. He took some leftover antibiotics but was no better after 6 d, when a heart murmur and an aortic valve nodule were discovered. He was presumed to have endocarditis with septic arthritis and was started on intravenous antibiotics. On the second hospital day, synovial fluid analysis revealed acute gout, and the patient improved very rapidly on anti-gout therapy. The valvular nodule remained unexplained, but one very rare cause of valvular heart nodules is visceral gout. An unsuccessful attempt to resorb the nodule was made by using allopurinol. This patient demonstrates several points about gout in endurance athletes: 1) acute gout can mimic infectious endocarditis, 2) misdiagnosed or undertreated gout often leads to multiple joint involvement and sometimes to visceral tophi, and 3) athletes who exercise in warm weather and quench their thirst with cold beer are at risk for acute gout.
 ...
PMID:Runner with gout and an aortic valve nodule. 767 64

A cross-sectional study of arthritis was conducted in the Rheumatology Department of the Brazzaville Teaching Hospital, Congo. A total of 473 patients with arthritis seen between 1989 and 1991 were subjected to the limited tests available. Gout was the leading diagnosis (n = 83). Septic arthritis (n = 82) and infectious discitis (n = 55) were the most common reasons for admission. Tests often failed to identify the causative organism; Staphylococcus was the most commonly recovered organism. Tuberculous discitis was less common than discitis due to pyogenic bacteria. HIV-related arthritis (n = 57) usually manifested as severe, febrile, asymmetrical, nonerosive, polyarthritis. Cases of rheumatoid arthritis (n = 29) fit the classical description of the disease. In 83 patients with monoarthritis, oligoarthritis, or polyarthritis, no etiology could be identified.
 ...
PMID:[Diagnosis of arthritis in black Africa. Apropos of 473 cases in Congo]. 792 May 24

The 1992 literature on septic arthritis reiterated the factors that portend a poor outcome in septic arthritis. However, we still know very little about how to improve the outcome for such patients. Infections of the musculoskeletal system may be more common among patients with HIV than the reported cases indicate. Bacterial endocarditis is frequently associated with musculoskeletal complaints. Low back pain may be a presenting manifestation. Acute gout and septic arthritis can cause peripheral arthritis in some patients with bacterial endocarditis. Septic arthritis can present unusual manifestations and can occur as a complication of arthroscopic surgery; the risk factors for its development after arthroscopy have been identified. Arthroscopy as a therapeutic procedure to drain an infected joint is discussed.
 ...
PMID:Bacterial arthritis. 835 41

In cases of unusual presentations, such as the three cases described here, gout or gouty arthritis may be misdiagnosed as rheumatoid arthritis, septic arthritis, or other rheumatic conditions and thus inappropriately treated. Microscopic analysis using compensated polarized light and culture of synovial fluid helps distinguish gouty arthritis from other arthropathies, and the presence of monosodium urate crystals establishes the diagnosis of gout. When gout is suspected, yet the initial examination does not reveal the telltale crystals, reexamination of synovial fluid is warranted. It is important for physicians to remember, though, that diagnosis of gout does not rule out the possibility of concurrent arthritic conditions.
 ...
PMID:Unusual presentations of gout. Tips for accurate diagnosis. 866 20

By definition, monoarticular arthritis means one-joint involvement, even though, in fact, such a condition is often an oligoarthritis because as many as two or three separate joints will be involved. Arthritis is often limited and may regress, so that it is frequently misdiagnosed. Sometimes, a monoarticular condition may be a polyarthritis onset (i.e., rheumatoid arthritis). Monoarticular arthritis can be caused by many factors, such as infections (septic arthritis), nonspecific inflammatory processes (reactive arthritis), crystals deposition (gout, CPPD crystal deposition disease), trauma, neoplasm (pigmented villonodular synovitis), immunologic conditions (amyloidosis) and hormonal changes (parathyroid disease). Its onset is usually acute and sometimes dramatic, with fever, pain and joint swelling, so that a decision must be made promptly to stop rapid illness evolution and to prevent the irreversible destruction of cartilage and bone (especially in septic arthritis). Diagnostic studies are performed with mono-bilateral radiographs of the joint. Radiographic findings (i.e., soft tissue swelling, joint effusion, widening and thinning of joint spaces, bone erosions and destruction of bone surface) are typical of the disease, but some findings (e.g., type of evolution and progression), laboratory tests, synovial biopsy and arthroscopy can differentiate infectious from inflammatory forms. Scintigraphy can depict isotopic joint uptake, before articular abnormalities are demonstrated with radiography, thanks to its high sensitivity; nevertheless, because of its low specificity, scintigraphy may miss some kinds of lesions (including osteoarthritis) and cannot easily differentiate osteomyelitis from septic arthritis. CT and MRI play a secondary, though not negligible, role, especially to study such deep infections as psoas abscesses, which may mimic arthritides.
 ...
PMID:[Monoarthritis]. 868 51

Pain and swelling at the first metatarsophalangeal joint can be caused by acute calcific periarthritis (ACP), an inflammatory condition resulting from deposition of hydroxyapatite crystals. A case is reported of a 23-year-old man in whom ACP was initially mistaken for gout, septic arthritis, and cellulitis. The diagnosis of ACP is based on the finding of inflammation around a joint along with radiographic evidence of periarticular soft tissue calcifications. Calcifications may disappear over time, as they did in this case. Failure to recognize this condition can lead to unnecessary testing and inappropriate treatment.
 ...
PMID:Hydroxyapatite pseudopodagra in a young man: acute calcific periarthritis of the first metatarsophalangeal joint. 892 43

During a 6-month period in 1994-1995, 0.7% of patient visits (51 visits of 47 patients) at the emergency unit of the Department of Medicine, Helsinki University Central Hospital, were due to joint symptoms. Infection seemed to play an important role as the etiologic factor for the joint complaints. Acute joint exacerbation in pre-existing arthritis was the reason for 11.7%, and suspected Baker's cyst for 3.9% of the visits. Confirmed (12.8%) or suspected reactive arthritis (10.6%), septic arthritis/spondylitis (6.4%), arthritis with inflammatory bowel disease (6.4%), and gout (14.9%) were the most common final diagnoses for the patients. In a quarter of the patients, the etiology for joint symptoms could not be confirmed. In conclusion, joint symptoms very seldom lead to visits to an emergency unit. In such cases, infection seems to be an important contributing factor. Patients with chronic rheumatic diseases only occasionally have to seek help at an emergency unit.
 ...
PMID:Arthritis patient as an emergency case at a university hospital. 905 99

Infectious arthritis in renal transplant patients may be a commonly diagnosed condition with traditional bacterial organisms isolated. However, since nontuberculous mycobacteria are ubiquitous in the environment, immunocompromised individuals may suffer from infections with these organisms. Concomitant gout and Mycobacterium avium intracellulare septic arthritis is described for the first time in this clinical setting. Appropriate cultures should be performed even in the setting of crystal arthritis in posttransplant patients when clinically indicated.
 ...
PMID:Coexistent gout and Mycobacterium avium-intracellulare arthritis in a renal transplant recipient. 919 13

A 74-year-old man with chronic lymphocytic leukemia, immune purpura, and gout presented with a painful, swollen ankle after a cat bite to his leg. On aspiration of the ankle, gram negative pleomorphic rods and monosodium urate crystals were seen and Pasteurella multocida was cultured. He was treated with ampicillin/sulbactam, joint aspiration, and intraarticular steroids, with resolution of infection and return of joint function. The syndromes of Pasteurella arthritis and crystal arthropathy with septic arthritis are reviewed.
 ...
PMID:Pasteurella multocida infectious arthritis with acute gout after a cat bite. 926 67

Septic arthritis is a medical and surgical emergency that if left untreated may lead to permanent joint disfigurement and loss of function. In the setting of chronic joint disease, the diagnosis, based on history and physical examination, may be difficult. A case is reported of a patient with a history of aspirate-proven gout presenting with symptoms of typical gouty exacerbation but diagnosed as septic arthritis and pseudogout.
 ...
PMID:Septic arthritis and calcium pyrophosphate deposition disease in the setting of chronic gout. 946 76


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>