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

The role of nuclear medicine in the diagnosis and management of the major arthropathies is critically reviewed, with particular reference to osteoarthritis, rheumatoid and similar forms of arthritis, ankylosing spondylitis, non-specific back pain, gout, the neuropathic joint, avascular necrosis, infection and the consequences of prosthetic joint insertion. Attention is drawn both to practical applications and deficiencies in current techniques and knowledge.
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PMID:Investigation of joint disease. 145 6

To understand the content of ambulatory family practice and find effective ways to improve clinical service, education and research in the Department of Family Medicine of Kaohsiung Medical College Hospital, we surveyed 14,064 patients from Jan. 1984 to Feb. 1991 and analysed (a) their basic demographic data including sex, age, insurance type, source and residential district and (b) clinical health problems covering 25,679 diagnoses and 148,994 diagnostic visits. Clinical health problems were recorded by the ICHPPC-2 code system. Results of basic demographic survey were as follow: 49.1% of patients was male and 50.9% female; 58.9% fell in the age group of 16-40 years and 22.4%, 12.0% and 6.7% of patients fell into the age groups of 41-65, under 16 and over 65 years respectively; 62.8% was insured usually by labor insurance and 26.9% had no insurance; the commonest referrals were other patients, colleagues, company personnel, doctors, media ... etc.; 58.8% lived in Kaohsiung City and 19.6% in Kaohsiung county. As for clinical health problems, the data showed that the commonest thirty diagnoses encountered at our clinic accounted for 69.3% of 25,679 diagnoses and the commonest ten diagnoses in descending order were medical health examination, acute URI, abdominal pain, uncomplicated hypertension, prophylactic immunization, hepatitis B carrier, back pain, anxiety disorder, viral hepatitis and irritable bowel syndrome. By calculating the average value of each diagnosis in a sample of 148,994 diagnostic visits to evaluate the habits of practice, we found that the commonest ten diagnostic visits at clinic in descending order were diabetes mellitus, hypertension involving target organ, uncomplicated hypertension, gout, hyperthyroidism, duodenal ulcer, tuberculosis, lipid metabolism disorder, other peptic ulcer and depressive disorders; all were chronic diseases. We concluded it was very important and helpful for the development of family medicine program and primary care unit to understand the content of their own ambulatory practice.
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PMID:[The content of ambulatory family practice in Kaohsiung Medical College Hospital]. 156 Apr 75

Many difficulties were encountered in a population survey of rheumatic complaints in a remote village area in the Philippines affecting the reliability of estimates of population prevalence. In phase I, a simple questionnaire identified 269 adults out of 950 who had rheumatic symptoms. In Phase II, 234 or 87% of positive respondents were requestioned using a more detailed pro forma. There were 196 with peripheral joint pain, 67 with neck pain and 137 with back pain. One third attributed their symptoms to work and 127 subjects had to stop work because of their complaints. Disability, including an inability to carry loads, affected nearly 1.8% of the population. Questions designed to detect rheumatoid arthritis and gout were not satisfactorily answered. Of those with complaints, 82% indicated that they still required help for their symptoms. In phase III, 166 subjects were medically examined. Osteoarthritis of the knee was found in 25 and 17 had Heberden's nodes. There were 16 with epicondylitis; 16 had rotator cuff pain and 35 had levator scapulae insertion pain. Three of these and three others had neck or shoulder swellings related to carrying loads on poles. Definite rheumatoid arthritis was diagnosed in two subjects and gout in five. No case of ankylosing spondylitis was identified. Thus, rheumatic complaints were common in this rural community and were frequently severe enough to cause disability and loss of time from work. Health worker education is required on how to handle these problems.
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PMID:Rheumatic disease in a Philippine village. II: a WHO-ILAR-APLAR COPCORD study, phases II and III. 178 84

Involvement of the axial skeleton in acute gouty arthritis has rarely been reported. Without the presence of peripheral tophi or history of gout, this diagnosis is often not considered. A patient is described with acute low back pain and for whom a diagnosis of acute axial gout was suggested after arthrocentesis of an asymptomatic peripheral joint yielded monosodium urate crystals. Treatment with colchicine led to prompt resolution of the gouty flare. Demonstration of urate crystals in this manner may encourage the clinician to attempt a trial therapy for acute gout, or at least to add gout to the differential diagnosis of acute back pain.
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PMID:Peripheral arthrocentesis in the work-up of acute low back pain. 213 51

In 24,964 employees of a shoe factory a retrospective analysis of the work incapacity on account of diseases of the locomotor system was made. On account of these diseases in the course of the calendar year 11.7% of the employees were unable to work and these diseases accounted for 19.5% of the sickness days. The largest number of work incapacities was in March and November. The mean period of work incapacity was 21.4 days. The shortest work incapacity was recorded in patients suffering from gout (13.2 days) and the longest one in patients with rheumatoid arthritis (125.4 days). The most frequent cause of work incapacity was back pain (62.2%), extraarticular rheumatism (17.4%) and osteoarthritis of the joints of the extremities (7.2%). Two hundred-sixty-four patients had in-patient treatment (9%). The greatest proportion of patients were hospitalized on account of back pain (54.9%). The mean period of hospitalization was 17.3 days. Between different factory medical officers relatively great differences in the number and length of granted work incapacity were found. The investigation revealed the importance of diseases of the locomotor system in the investigated shoe factory and the need to investigate the influence of the working environment and occupation on clinical manifestations of affections of the locomotor system.
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PMID:[Disease of the locomotor system in a shoe factory]. 214 Jul 14

Colchicine, a drug used for centuries in the treatment of gout, has been reported to be effective for low-back pain due to disc disorders. A prospective, randomized, double-blind study evaluating the therapeutic effect of intravenous colchicine was conducted in a group of patients with low-back pain with symptoms originating less than 6 months previously. Each patient completed a questionnaire and a pain drawing. Laboratory studies including uric acid and sedimentation rate were performed, as was a detailed physical examination and lumbar thermography. All treatment parameters (including physical therapy, anti-inflammatory medications, and instructions) were constant except that each patient received either intravenous colchicine or intravenous saline. Results indicate a significant difference between the two groups, the intravenous colchicine group showing improvement in symptoms for a few hours or days over a 3-week course of treatment. However, the relief was often of short duration.
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PMID:Intravenous colchicine for low-back pain: a double-blind study. 214 45

The migration of 1381 Tokelauans 15 years and over to New Zealand leaving 811 in Tokelau, provided a unique opportunity to test centuries of speculation on the impact of environment on rheumatic disease. There was no change in all rheumatic complaints. The migrant men had more gout, joint pain following injury, and neck pain. The migrant women had more dorsal back pain. There was no change in the prevalence of clinically defined osteoarthritis (COA) despite positive associations with weight and higher weights in the migrants. Rheumatoid arthritis was infrequent in both populations. Low back pain was common but was not more common in migrants, though compensation payments are readily available in New Zealand and are not in the Islands.
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PMID:Rheumatic complaints in Tokelau. II. A comparison of migrants in New Zealand and non-migrants. The Tokelau Island migrant study. 295 66

The cases of a 43 years old-man with gout and a 24 years-old woman with severe back pain who developed dextro-propoxyphene addiction during pain treatment are reported. They had severe edema and fibrosis of skin, subcutaneous tissue and muscle involving the upper and lower limbs. ESR was elevated, CPK and LDH were normal. EMG in proximal muscles showed decreased duration and voltage of potentials, excess of short polyphasics and increased recruitment (BSAP), with positive waves and fibrillations; distal muscles had fasciculations, fibrillations, positive waves, normal voluntary potentials, decreased recruitment. Lymphography indicate delayed progression of contrast media and obstruction in the thighs. Muscle biopsy on fresh-frozen section and histochemistry showed extensive connective tissue proliferation with intense acid and alkaline phosphatase activity in the perimysial and endomysial area, infiltration of lymphocytes near and around small vessels and capillaries. There were perifascicular and type II fiber atrophy. After discharge the patients returned to propoxyphene addiction and the symptoms who subsided during drug withdrawal come back again. New admission, new drug withdrawal and they were discharged free of symptoms and pathologic changes.
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PMID:[Myopathy caused by propoxyphene: report of 2 cases with muscle histochemistry]. 616 47

A postal survey among 2% of men in Leeds showed that the prevalence of urinary stone disease is 3.8%. The prevalence of upper urinary tract and spontaneously passed stones increases progressively from 0.7% in social class 5 to 5.0% in social class 1 but that of bladder stones (0.7% in the group as a whole) is independent of social class. There is an initial peak of upper urinary tract and spontaneously passed stones commencing at age 20 and having a projected prevalence at age 90 of 5.7% and a second peak of bladder stones, commencing about age 50, with a projected prevalence of 1.9%. The prevalence of stone disease increases according to the order: single less than divorced/separated less than married less than widowed men. A family history of stones tends to be higher amongst relatives of stone-formers than amongst the corresponding relatives of control subjects, the male/female ratio being 2:1. The occurrence of urinary stones is significantly associated with that of gallstones, high blood pressure, backache, arthritis and gout but not with that of peptic ulcer, diabetes, thyroid disease or bronchitis.
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PMID:Studies on the prevalence and epidemiology of urinary stone disease in men in Leeds. 622 82

A review of 290 patients with Paget's disease of bone revealed 83% had one or more rheumatic syndromes. The most common finding was back pain (37%), most often related to an independent osteoarthritic process or Paget's disease precipitating or complicating spinal osteoarthritis. Paget's disease as a sole source of back pain was distinctly uncommon (2%). Osteoarthritis related to Paget's disease was present in the hip (30%) and knee (11%). Paget's disease in spondylitis was present in 4 patients and in ankylosing hyperostosis in 4 patients. The latter group had very active Paget's disease. Rheumatoid arthritis (1%), hyperuricemia (20%), and gout (4%) did not appear increased in this group.
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PMID:Musculoskeletal manifestations of Paget's disease of bone. 644 3


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