• Corpus ID: 22585989

Diagnosis of gout: clinical, laboratory, and radiologic findings.

@article{Schlesinger2005DiagnosisOG,
  title={Diagnosis of gout: clinical, laboratory, and radiologic findings.},
  author={Naomi Schlesinger},
  journal={The American journal of managed care},
  year={2005},
  volume={11 15 Suppl},
  pages={
          S443-50; quiz S465-8
        }
}
  • N. Schlesinger
  • Published 15 November 2005
  • Medicine
  • The American journal of managed care
Acute gouty arthritis typically presents with a sudden and severe exquisitely painful joint, most classically in the first metatarsophalangeal joint (toe). Demonstrating the presence of monosodium urate (MSU) crystals in the joint fluid or tophus has been the gold standard for the diagnosis of gout. However, many physicians do not perform synovial fluid analysis. In the absence of demonstrating the presence of MSU crystals in aspirated joint fluid or tophus, clinical, radiologic, and laboratory… 
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A Case of Secondary Gout Associated with Essential Thrombocythemia
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References

SHOWING 1-10 OF 39 REFERENCES
Advanced imaging of gout.
TLDR
Characteristic of gout are well-defined, punched-out erosion with overhanging edges, with preservation of the joint space, lack of periarticular osteopenia, asymmetrical involvement, soft tissue nodules, and intraosseous calcifications.
Tophi as the initial manifestation of gout. Report of six cases and review of the literature.
TLDR
Six cases of tophi in the absence of prior episodes of gouty arthritis are presented and a review of previously published cases shows no clear explanation is found.
Radiographic features of gout.
TLDR
Although gout has a predilection for the first metatarsophalangeal joint, it may also affect the feet, hands, wrists, elbows and knees.
Urate-mediated inflammation in nodal osteoarthritis: clinical and roentgenographic correlations.
TLDR
It is concluded that urate crystals mediate episodes of acute inflammation in certain patients with nodal OA, noted primarily in elderly patients of both sexes, especially in those receiving diuretic therapy.
Gout: how presentation, diagnosis, and treatment differ in the elderly.
Although frequently a typical acute monoarticular arthritis, gout in the elderly is often a chronic, polyarticular disease, sometimes with minimal inflammation. It can be associated with
Polyarticular Versus Monoarticular Gout: A Prospective, Comparative Analysis of Clinical Features
TLDR
No single laboratory or synovial fluid value meaningfully distinguishes patients with polyarticular from those with monoarticular gout, reflecting chronicity associated with poor patients understanding, poor patient compliance, and suboptimal physician management.
The misdiagnosis of gout and hyperuricemia.
TLDR
Misdiagnosis was more likely in those with psoriatic arthritis and pseudogout and less common in patients with nonspecific arthralgias, but incorrectly diagnosed patients received allopurinol while slightly more than 15% were treated with uricosuric agents.
A comparison of gout in men and women. A 10-year experience.
TLDR
In women, polyarticular/tophaceous disease was often the first manifestation of gout, and a preceding recurrent mono-arthritis was found in joints other than the big toe, and the duration of disease before tophi appeared was shorter.
The clinical spectrum of gouty arthritis in women.
TLDR
Gout in women is overwhelmingly postmenopausal, apparently associated with diuretic therapy and renal insufficiency independent of the effects of age, and apparently associated in men with crystal-proved gout as well.
Monosodium urate crystals in the knee joints of patients with asymptomatic nontophaceous gout.
TLDR
Knee joint aspiration is a sensitive method for the demonstration of MSU crystals in asymptomatic patients and might also be useful in documenting these crystals in patients who have had attacks of arthritis with features consistent with a diagnosis of gout, but in whom MSUstals have not been documented.
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