of the knee: revisiting MRI patterns in 30 patients.
Using the patient's history, the finding from physical examination, the laboratory findings, and radiologic features found on plain radiographs, CT, or MRI are all helpful in making the proper diagnosis of chronic tophaceous gout
(%) Male gender 47 (979%) Age, years (mean [+ or -] SD) 56.6 [+ or -] 11.4 Alcohol abuse 18 (375%) Smoking 4 (8.3%) Hypertension (BP [greater than or 38 (79.1%) equal to] 140/90 mmHg) Diabetes mellitus (fasting glucose 10 (21%) > 126 mg/dL) Hypertriglyceridemia 20 (41.6%) ([greater than or equal to] 150 mg/dL) Obesity (BMI [greater than or 9 (18.75%) equal to] 30) Osteoarthritis 16 (33.3%) Positive family history 8 (16.7%) Precipitating factor 23 (48%) Podagra 35 (73%) Chronic tophaceous gout
23 (48%) TABLE 2: Change in serum uric acid (UA) with allopurinol, benzbromarone, or both drugs.
Today's approval is reportedly the first approved therapy in the EU to address a significant unmet medical need for patients with chronic tophaceous gout
. Until the product becomes commercially available in the EU, the company will continue to provide KRYSTEXXA to patients through the established Named Patient Programme (NPP).
Focal calcifications around joints similar to tophaceous gout
may be also seen in patients with pseudogout (Figure 5).
The clinical manifestations of gout (acute gouty arthritis, gouty arthropathy, chronic tophaceous gout
, uric acid urolithiasis, and gouty nephropathy) result from deposition of monosodium urate or uric acid crystals from supersaturated body fluids.
The fourth and most disabling stage is chronic tophaceous gout
, a condition that can develop over a period as long as 10 years.
Prophylactic therapy is indicated when frequent attacks occur and when complications or tophaceous gout
Studies on the interaction of rheumatoid factor with monosodium urate crystals and case report of coexistent tophaceous gout
and rheumatoid arthritis.
(2-4) Tophaceous gout
, however, occurs in less than 10% of cases.
Since this patient had a history of severe tophaceous gout
, his primary physician administered a shot of Depo-Medrol to relieve some of the pain caused by the gout flare.