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

As there have been no previous studies, we undertook a systematic review to determine the number and nature of musculo-skeletal complaints presenting to casualty departments, review the appropriateness of treatment and referrals to other departments and also to identify potential problem areas so as to address these. Over the review period of 40 non-consecutive days, the total attendance was 2863 patients of which 85 (2.97%) presented with musculo-skeletal complaints. The majority (691) were in the age group of 20-59 years. Most complaints were in the back (26), neck (11), chest (10), shoulder (8), knee (8). Main complaints were pain (78), tenderness (10), swelling (9), stiffness (9), reduced movements (8) or a combination thereof; the rest were miscellaneous, e.g. pyrexia, headache and paraesthesia. The majority had a duration of symptoms from 1 to 7 days. Investigations at the casualty department were radiographs (29), full blood count (6), biochemistry (6), erythrocyte sedimentation rate (ESR) (1), blood culture (1), electrocardiogram (ECG) (7), and joint aspiration (2). Advice was sought from orthopaedic (2), rheumatology or general medicine (0), or other departments (2). Casualty diagnoses were mainly non-inflammatory conditions. Treatment given included analgesics/non-steroidal inflammatory drugs (NSAIDs) (44), splints and slings (5), Tubigrip (6), and collars (5). Only two patients (2.4%) were admitted. We were pleasantly surprised to note very small numbers of patients with inflammatory conditions, possibly indicating previous optimal management in our locality. A surprising finding was the lack of any attendance with gout. More direct referrals to orthopaedic or rheumatology departments would be appropriate in some instances. As a result of this review, we decided to offer short courses on musculo-skeletal medicine for new casualty officers and we have also produced guidelines/algorithm for management which would be equally useful for general practitioners.
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PMID:A review of accident and emergency attendances for non-traumatic musculo-skeletal complaints. 1098 34

Patients with parathyroid disease can have important musculoskeletal problems.Hypoparathyroidism can cause subcutaneous calcifications, tetany, muscle cramps,and paresthesias, but also myopathies and an ankylosing spondylitis-like back disease. Hypoparathyroidism can occur in SLE caused by antiparathyroid antibodies.Patients with hyperparathyroidism can develop bone disease with cysts, erosions,and deformities. They can also develop pseudogout, gout, myopathies, and tendon ruptures.
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PMID:Parathyroid disease. 2109 44

Gout is clinically characterized by episodes of monoarthritis, but if not treated properly, it can lead to a chronic polyarthritis, which may eventually mimic rheumatoid arthritis (RA). We present the case of a 59-year-old man, with a history of symmetrical polyarthritis of the large and small joints with later development of subcutaneous nodules, which was initially misdiagnosed as RA, being treated with prednisone and methotrexate for a long period of time. He complained of occipital pain and paresthesia in his left upper limb, and computed tomography (CT) and magnetic resonance imaging (MRI) revealed the presence of an expansive formation in the cervical spine with compression of the medulla. He was admitted for spinal decompressive surgery and the biopsy specimen demonstrated a gouty tophus. Chronic gout can mimic RA and rarely involves the axial skeleton, and thus its correct diagnosis and the implementation of adequate therapy can halt the development of such damaging complications.
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PMID:Gout initially mimicking rheumatoid arthritis and later cervical spine involvement. 2557 18

Colchicine is a relatively safe medication that is widely used for both prevention and treatment of gout attack. However, serious adverse events, including myoneuropathy and multiorgan failure, have been reported. We report a case of colchicine-induced myoneuropathy in a female kidney transplant recipient who had been taking cyclosporine. She developed gastrointestinal discomfort and paresthesia 5 days after the initiation of colchicine. She showed signs of myoneuropathy, and hepatic and renal injury. Colchicine toxicity was suspected, and colchicine was discontinued. Her symptoms and laboratory findings improved gradually. Literature was reviewed for previous reports of colchicine-induced myoneuropathy in solid organ transplant recipients.
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PMID:Colchicine-induced myoneuropathy in a cyclosporine-treated renal transplant recipient. 2687 17

Non-infectious soft tissue lesions of the foot and ankle are relatively rare clinically. These include benign and malignant neoplasms, as well as non-neoplastic or pseudotumoral lesions such as ganglionic, synovial and epidermoid cysts, intermetatarsal and adventitious bursitis, inflammatory lesions like gouty tophi and rheumatoid nodules, Morton's neuroma, and granuloma annulare. A 48-year-old male with a history of medically treated tophaceous gout presented with left foot neuropathic pain and paresthesia, in the setting of a well-circumscribed soft tissue lesion of the second intermetatarsal space, suspected to be a Morton's neuroma. Magnetic resonance imaging (MRI) showed a 4.1 x 2.7 x 2.6 cm heterogeneous soft tissue mass containing multiple cystic areas. Excisional biopsy was performed and histologic examination revealed well-circumscribed nodules of amorphous material containing needle-shaped clefts, rimmed by histiocytes, and multinucleated giant cells consistent with a gouty tophus. This is the first case reported in the literature of an intermetatarsal gouty tophus causing neuropathic pain and paresthesia. While Morton's neuroma is the most common cause of this presentation, this case illustrates that other pseudotumoral lesions, such as a gouty tophus, may present similarly, and should be considered in the differential diagnosis. While most cases of tophaceous gout can be adequately treated with urate-lowering therapy, surgery may be indicated for tophi that do not resolve with medical treatment based upon symptom severity, compression of nearby structures, and functional impairment.
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PMID:A Case of a Second Intermetatarsal Space Gouty Tophus with a Presentation Similar to a Morton's Neuroma. 3002 12