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QJM Advance Access originally published online on February 15, 2008
QJM 2008 101(5):417; doi:10.1093/qjmed/hcm143
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© The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Advanced gout

Dr. I. Marie, Dr. M. Parrad, Dr. L. Lahaxe, Dr. H. Levesque and Dr. C. Houdent

Department of Internal Medicine, Rouen University Hospital, 76031 Rouen Cedex, France.

email: isabelle.marie{at}chu-rouen.fr

A 95-year-old woman presented with a 20-year-history of chronic polyarthritis involving the small joints of her hands, feet, as well as elbows and ankles. Over the past 7 years, she had become progressively disabled by both pain and large nodules that had formed on her fingers. Laboratory findings disclosed increased uric acid level 699 µmol/l. Autoantibody screening tests were negative. Bone radiographs of the hands showed extensive erosive changes of her distal and proximal interphalangeal joints, with ‘overhanging edges’ and dense soft tissue masses in the areas surrounding these abnormalities. In this patient, the appearance of prominent tophi and elevated serum urate levels confirmed the diagnosis of gout. Gout affects more than 1% of adults, being the most common form of inflammatory arthritis in men. It is crucial to recognize that the course of classic gout passes through various stages, i.e. asymptomatic hyperuricemia, intermittent gouty arthritis and chronic tophaceous gout. In particular, advanced gout can be focused with other causes of chronic inflammatory arthritis such as rheumatoid arthritis. Formula


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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
101/5/417    most recent
hcm143v1
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Right arrow Articles by Marie, I.
Right arrow Articles by Houdent, C.
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