 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
16 November 1999 | Volume 131 Issue 10 | Pages 756-759
Background: The diagnosis of gout in the intercritical phase can be difficult.
Objective: To determine whether synovial fluid analysis allows the diagnosis of intercritical gout.
Design: Cross-sectional study.
Setting: Outpatient rheumatology clinics.
Patients: 101 patients with gout.
Intervention: Arthrocentesis of 80 knees and 21 first metatarsophalangeal joints (each joint from a different patient) that had been inflamed but were currently asymptomatic.
Measurements: Frequency with which arthrocentesis yielded synovial fluid; presence of monosodium urate crystals in the synovial fluid sample; and, for synovial fluid with crystals, the number of microscope fields that had to be scanned before crystals were found.
Results: Synovial fluid was obtained from 91 of 101 joints. The fluid from all 43 patients not receiving hypouricemic agents contained monosodium urate crystals. These crystals were found in the synovial fluid of only 34 of 48 patients receiving hypouricemic agents. In 90% of the synovial fluid samples that contained crystals, crystals were seen in the first five microscope fields examined.
Conclusions: Arthrocentesis of asymptomatic knees and first metatarsophalangeal joints and synovial fluid analysis are simple procedures that facilitate the diagnosis of gout during intercritical periods.
Author and Article Information
From Hospital General Universitario de Alicante, Hospital de la Marina Baja, and Hospital General de Elche, Alicante, Spain.
Acknowledgment: The authors thank Dr. Laura Fry for her help with the English version of this manuscript and for useful comments on the text.
Grant Support: In part by Fondo de Investigación Sanitaria grant 96/1212.
Requests for Reprints: Eliseo Pascual, MD, PhD, Hospital General Universitario de Alicante, Maestro Alonso 109, 03010 Alicante, Spain; e-mail, e.pascual{at}san.gva.es. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.
Current Author Addresses: Drs. Pascual, Batlle-Gualda, Martínez, and Velda: Hospital General Universitario de Alicante, Maestro Alonso 109, 03010 Alicante, Spain.
Dr. Rosas: Hospital Marina Baja, Partida Galandu 5, 03570 Villajoyosa, Alicante, Spain. BRIEF COMMUNICATION
Synovial Fluid Analysis for Diagnosis of Intercritical Gout
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  S.-J. Chang, C.-J. Chen, F.-C. Tsai, H.-M. Lai, P.-C. Tsai, M.-H. Tsai, and Y.-C. Ko Associations between gout tophus and polymorphisms 869T/C and -509C/T in transforming growth factor {beta}1 gene Rheumatology, May 1, 2008; 47(5): 617 - 621. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Sivera, R Aragon, and E Pascual First metatarsophalangeal joint aspiration using a 29-gauge needle Ann Rheum Dis, February 1, 2008; 67(2): 273 - 275. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Pascual and F. Sivera Why is gout so poorly managed? Ann Rheum Dis, October 1, 2007; 66(10): 1269 - 1270. [Full Text] [PDF]
|
|
|
|
|
|
E. Roddy, W. Zhang, and M. Doherty Are joints affected by gout also affected by osteoarthritis? Ann Rheum Dis, October 1, 2007; 66(10): 1374 - 1377. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Roddy, W. Zhang, and M. Doherty Concordance of the management of chronic gout in a UK primary-care population with the EULAR gout recommendations Ann Rheum Dis, October 1, 2007; 66(10): 1311 - 1315. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Pascual and F. Sivera Time required for disappearance of urate crystals from synovial fluid after successful hypouricaemic treatment relates to the duration of gout Ann Rheum Dis, August 1, 2007; 66(8): 1056 - 1058. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W Zhang, M Doherty, E Pascual, T Bardin, V Barskova, P Conaghan, J Gerster, J Jacobs, B Leeb, F Liote, et al. EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the standing committee for international clinical studies including therapeutics (ESCISIT) Ann Rheum Dis, October 1, 2006; 65(10): 1301 - 1311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A Martinez Sanchis and E Pascual Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy Ann Rheum Dis, December 1, 2005; 64(12): 1769 - 1772. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E Suresh Diagnosis and management of gout: a rational approach Postgrad. Med. J., September 1, 2005; 81(959): 572 - 579. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Dalbeth and D. O. Haskard Mechanisms of inflammation in gout Rheumatology, September 1, 2005; 44(9): 1090 - 1096. [Full Text] [PDF]
|
|
|
|
|
|
A Swan, H Amer, and P Dieppe The value of synovial fluid assays in the diagnosis of joint disease: a literature survey Ann Rheum Dis, June 1, 2002; 61(6): 493 - 498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Amer, A. Swan, and P. Dieppe The utilization of synovial fluid analysis in the UK Rheumatology, September 1, 2001; 40(9): 1060 - 1063. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Johnson Diagnosis of Intercritical Gout Ann Intern Med, May 16, 2000; 132(10): 843 - 843. [Full Text] [PDF]
|
|
|
|
 |
|
 Diagnosis of Gout When Patients Are Asymptomatic Journal Watch (General), December 7, 1999; 1999(1207): 5 - 5. [Full Text]
|
|
Article
