|
Criteria for the
Classification of Acute Gouty
Arthritis
A.
Presence of characteristic
urate crystals in the joint
fluid, or
B.
Presence of a tophus proven
to contain urate crystals by
chemical means or polarized
light microscopy, or
C.
Presence of six of the
following clinical,
laboratory, and radiographic
phenomena:
-
More
than one attack of acute
arthritis.
-
Development of maximal
inflammation within 1 day.
-
Attack
of monarticular arthritis.
-
Observation of joint
redness.
-
Pain or
swelling in first
metatarsophalangeal joint.
-
Unilateral attack
involving first
metatarsophalangeal joint.
-
Unilateral attack
involving tarsal joint.
-
Suspected tophus.
-
Hyperuricemia.
-
Asymmetric swelling within
a joint on x-ray.
-
Subcortical cysts without
erosions on x-ray.
-
Negative culture of joint
fluid for microorganisms
during attack of joint
inflammation.
Comparison of Gout and
Pseudogout
|
|
Gout |
Pseudogout |
|
Ratio
of men to women |
7:1 |
1:1.5 |
|
Age
group affected |
Men
>40 years old
Postmenopausal women |
Elderly |
|
Serum
urate |
Elevated |
Normal |
|
Joints involved |
First
metatarsophalangeal (MTP)
joint, insteps, knees,
wrists, fingers,
olecranon bursae |
Knees, wrists, ankles |
|
Involvement of first MTP
(podagra) |
Common |
Rare |
|
Tophi |
Present |
Rare
tophi-like
deposits |
|
Radiographic findings |
Erosions with
overhanging edges |
Chondrocalcinosis |
|
Crystals |
Needle-shaped, strong
negative birefringence
|
Rhomboid-shaped, weakly
positive birefringence |
References:
-
Wallace SL, Robinson
H, Masi AT, Decker JL,
McCarty DJ, Yu TF.
Preliminary criteria
for the classification
of the acute arthritis
of primary gout.
Arthritis Rheum. 1977
Apr;20(3):895-900.
[Medline]
-
Schlesinger N.
Diagnosis of gout:
clinical, laboratory,
and radiologic
findings. Am J Manag
Care. 2005 Nov;11(15
Suppl):S443-50.
[Medline]
Sponsored Links
|
Harrison's Principles of Internal Medicine 16e (Two-Volume Set), by D. Kasper, E. Braunwald, A. Fauci, S. Hauser, D. Longo, J.Jameson
16 edition (July 27, 2004)
Current Medical Diagnosis & Treatment, 2005, by L. Tierney, S. McPhee, M. Papadakis
44 edition (October 19, 2004)
Washington Manual of Medical Therapeutics, 31st Edition, by G. Green, I. Harris, G. Lin, K. Moylan
31st Sprl edition (March 1, 2004)
|
