Diagnosis of chronic gout: evaluating the american college of rheumatology proposal, European league against rheumatism recommendations, and clinical judgment
| Autor: | Rubén Burgos-Vargas, Jesús Espinoza, Lizandra Hernández Roque, Adolfo Hernández Garduño, Lucio Ventura, Jorge A. Esquivel-Valerio, Clara Shumsky, Francisco J. Aceves, Leobardo Terán, Claudia Berenice Hernández Cuevas, Ingris Peláez-Ballestas, Janitzia Vázquez-Mellado, María Victoria Goycochea-Robles, Ana Guilaisne Bernard |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Gout Immunology Pain Guidelines as Topic Hyperuricemia Toe Joint Cohort Studies Podagra Rheumatology Internal medicine medicine Immunology and Allergy Outpatient clinic Humans European Union Mexico Oligoarthritis biology business.industry Gold standard Middle Aged medicine.disease biology.organism_classification Uric Acid Cross-Sectional Studies Chronic Disease Physical therapy Female business Crystallization Rheumatism |
| Zdroj: | The Journal of rheumatology. 37(8) |
| ISSN: | 0315-162X |
| Popis: | Objective.Observation of monosodium urate (MSU) crystal is the gold standard for diagnosis of gout, but is rarely performed in daily clinical practice, and diagnosis is based on clinical judgment. Our aim was to identify clinical and paraclinical data included in the European League Against Rheumatism recommendations (EULARr) and American College of Rheumatology proposed criteria (ACRp) for diagnosis of gout in patients with chronic gout according to their attending rheumatologists.Methods.This cross-sectional and multicenter study included consecutive patients from outpatient clinics with a diagnosis of gout by their attending rheumatologists according to their expertise. The frequency of each item from the ACRp and EULARr was determined. Possible combinations of the items that were frequent, clinically relevant, and simple to evaluate in daily practice were determined.Results.We studied 549 patients (96% men), mean age 50 ± 14 years. Analysis of MSU crystals was performed in 15%. We selected 7 clinical criteria and 1 laboratory measure because of their frequency, importance, and simplicity to obtain: current or past history of: > 1 attack of acute arthritis (93%); mono or oligoarthritis attacks (74%); rapid progression of pain and swelling (< 24 hours; 74%); podagra (70%); erythema (56%); unilateral tarsitis (33%); tophi (52%); and hyperuricemia (93%). The chronic gout diagnosis (CGD) proposal comprised ≥ 4/8 of these; 88% of patients had the criteria of the CGD proposal while 75% had 6/11 ACRp criteria (p = 0.001). When analysis of MSU crystals was added, 90.1% (CGD) and 83.9% (ACRp) met the criteria (p = 0.004).Conclusion.Current or past history of ≥ 4/8 CGD parameters is highly suggestive of chronic gout. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|